Medical Biller

About Us: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.Qualifications:

• 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

Key Responsibilities:

• 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

Education and Experience:• High school diploma or equivalent required• Medical billing or coding certification is a plusBenefits:• 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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