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Surgical Commercial Billing & Collections Specialist

Human Hire

Clifton, NJ

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JOB DETAILS
SALARY
$26–$30 Per Hour
SKILLS
Accounts Receivable, Billing, Billing Records, Credit and Collections, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), ICD-10, Insurance, Insurance Documentation, Medical Billing, Microsoft Excel, Negotiation Skills, Orthopedics, Podiatry, Problem Solving Skills, Reconciliation, Record Keeping, Reimbursement, Revenue Management, Surgical Procedures
LOCATION
Clifton, NJ
POSTED
30+ days ago

Medical Billing & Collections Specialist (Commercial & Out-of-Network Surgical Focus)
Full-Time | Monday–Friday | Clifton, NJ
$26-30/hr | Benefits including pension, 401k, PTO & more
About the Role
We are seeking an experienced Medical Billing & Collections Specialist to manage the full revenue cycle for high-value surgical claims within a specialty surgical environment. This role focuses heavily on commercial insurance and out-of-network reimbursement, with a strong emphasis on complex denial management, appeals, and payer negotiation.

You’ll be working in a fast-paced, specialty-driven setting supporting neuro-spine, orthopedic, and podiatry surgical billing where accuracy, persistence, and strong payer knowledge directly impact reimbursement outcomes.
What You’ll Do
  • Manage end-to-end billing and collections for commercial and out-of-network surgical claims
  • Follow up on unpaid and underpaid claims, particularly high-dollar surgical procedures
  • Investigate, appeal, and resolve complex claim denials
  • Communicate with insurance carriers, providers, and patients to resolve billing issues
  • Negotiate reimbursement outcomes for out-of-network and underpaid claims
  • Review and interpret Explanation of Benefits (EOBs) and payer policies
  • Reconcile payments and ensure accurate claim resolution
  • Maintain detailed records of billing activity, appeals, and collection efforts
  • Support patients with billing questions and payment plan options
What We’re Looking For
  • 5+ years of medical billing and collections experience
  • Strong background in commercial insurance billing required
  • Out-of-network (OON) billing experience strongly preferred
  • Experience with surgical specialties such as neuro-spine, orthopedics, or podiatry required or highly preferred
  • Strong understanding of ICD-10, CPT, and HCPCS coding
  • Experience handling appeals, denials, and payer negotiations
  • Proficiency with billing systems and Microsoft Excel
Nice to Have
  • Experience in specialty surgical practices or high-volume provider groups
  • Familiarity with reimbursement disputes and contract variance resolution
  • Prior experience working complex A/R aging reports
Why This Role Stands Out
This is a high-impact billing role focused on specialty surgical claims where your work directly influences revenue recovery. You’ll gain deep exposure to complex commercial payer strategies, out-of-network reimbursement negotiation, and high-dollar surgical billing workflows in a specialized clinical environment.

About the Company

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Human Hire