Job Information
Total Orthopedics and Sports Medicine Billing Customer Services Representative in Syosset, New York
Billing Customer Service Representative
Our growing orthopedic practice is seeking a Billing Customer Service Representative to assist patients with billing inquiries, payment processing, and insurance claim resolutions. This role requires strong communication skills, attention to detail, and a solid understanding of medical billing processes, particularly in orthopedic services. The ideal candidate is customer service-oriented and comfortable working in a fast-paced healthcare environment.
Responsibilities: Handle patient inquiries regarding billing statements, insurance coverage, co-pays, deductibles, and payment plans. Explain orthopedic procedure costs, including surgeries, imaging (X-rays, MRIs), and durable medical equipment (DME). Process payments, set up payment arrangements, and assist with financial hardship applications. Investigate and resolve claim denials, coding errors, and billing discrepancies by coordinating with insurance companies and internal billing teams. Verify insurance coverage and benefits for orthopedic procedures and ensure proper documentation. Work closely with orthopedic providers, medical coders, and front desk staff to ensure accurate charge entry and claim submission. Educate patients about prior authorization requirements and out-of-pocket costs. Maintain accurate patient account records and update payment statuses in the practice management system. Ensure compliance with HIPAA, Medicare, and other billing regulations related to orthopedic care. Assist with administrative tasks such as billing reports and reconciliation of outstanding balances. Qualifications: High school diploma or equivalent (Associates degree or certification in medical billing is a plus). 1-2 years of experience in medical billing, customer service, or a healthcare setting (orthopedic experience preferred). Knowledge of insurance policies, EOBs, ICD-10, CPT codes, and orthopedic procedure billing. Proficiency in billing software (such as NextGen, Athenahealth, or other EHR systems). Strong problem-solving skills to resolve patient and insurance billing concerns. Excellent verbal and written communication skills to interact professionally with patients and insurance representatives. Ability to multi-task and work efficiently in a high-volume orthopedic practice. Familiarity with workers compensation, auto injury claims, and prior authorizations is a plus. Work Environment & Schedule: Full-time (40 hours) Office-based role with potential hybrid work options depending on practice policies