Medical Biller
Agility Billing Services
Ronkonkoma, NY
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JOB DETAILS
JOB TYPE
Full-time
LOCATION
Ronkonkoma, NY
POSTED
26 days ago
At Agility Billing Services, we are dedicated to providing exceptional care and service in the orthopedic and pain management field. We are seeking a skilled and motivated Accounts Receivable Team Lead for commercial claims to join our team. The ideal candidate will have significant experience in collections, medical billing, and a strong understanding of commercial insurance carriers and Medicare.
Position Overview:
We are seeking a Medical Biller to join our team and support billing and collections for a busy surgical practice. The ideal candidate will have experience in medical claims follow-up, with a strong understanding of commercial and Medicare insurance plans and out-of-network billing. Prior experience in orthopedic, spine, or pain management services is highly preferred.
• Working knowledge of commercial and Medicare insurance, including plan guidelines
• Experience with out-of-network billing processes; understanding of the IDR process and appeals is a plus
• Ability to review EOBs, denials, and payer communications to ensure timely appeals and maximize revenue capture • Serve as an escalation point for complex, high-dollar, or unresolved commercial and Medicare claims from the AR team
• Excellent communication skills, particularly when working with insurance representatives and internal teams
• Proficient in ICD-10, CPT, and modifier usage
• Experience billing for orthopedic, spine, or pain management services is preferred but not required
• Strong problem-solving and organizational skills
• Self-motivated with the ability to work independently and meet deadlines
• Monitor, review, and follow up on outstanding commercial and Medicare claims, providing advanced support and serving as an escalation resource for unresolved, unpaid, or underpaid claims to ensure timely reimbursement
• Review, appeal, and resolve complex claim denials or payment discrepancies, including escalated issues from the AR team, using payer portals and payer communications
• Maintain up-to-date knowledge of payer policies (including LCDs), billing regulations, and coding guidelines
• Collaborate with clinical and administrative teams to ensure accurate documentation and billing practices
• Maintain organized and detailed records of claim activity, account status, and insurance correspondence
• High school diploma or equivalent required
• Medical billing or coding certification is a plus
• Competitive compensation based on experience, skills, and growth potential
• Opportunities for professional development and advancement in a specialty billing role
• Supportive, team-oriented work environment
• Hybrid position available after a 90-day probationary period
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