Bilingual Accounts Receivable Specialist

Bilingual Accounts Receivable Specialist

Pay: $17.50–$19.00 per hour
Job Type: Full-time
Schedule: Monday–Friday
Work Location: In person

Job Summary

We are seeking an experienced Bilingual Accounts Receivable Specialist to join our orthopedic practice. This position is responsible for actively managing outstanding insurance accounts receivable, identifying and resolving unpaid or underpaid claims, working denials and appeals, and helping ensure timely and accurate reimbursement for services provided.

The ideal candidate will be bilingual in English and Spanish, have previous medical billing or accounts receivable experience, and possess a strong understanding of Medicare, Medicare Advantage, PPO, POS, HMO, and commercial insurance plans.

This is a hands-on A/R position requiring strong follow-up skills, attention to detail, knowledge of CPT and ICD-10-CM coding, and the ability to identify why a claim has not been paid and take the appropriate action to resolve it.

Responsibilities

• Work insurance accounts receivable and follow up on outstanding claims.
• Review A/R aging reports and prioritize accounts requiring immediate action.
• Investigate unpaid, underpaid, rejected, and denied claims.
• Contact insurance companies and utilize payer portals to determine claim status.
• Correct billing and claim errors and submit corrected claims when appropriate.
• Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) for payment and denial information.
• Identify denial trends and assist in preventing recurring billing issues.
• Prepare and submit claim reconsiderations, disputes, and appeals with appropriate supporting documentation.
• Follow up on submitted appeals and corrected claims through resolution.
• Verify insurance eligibility, benefits, referrals, and authorization information when necessary to resolve outstanding claims.
• Review CPT, ICD-10-CM, modifiers, and other claim information for accuracy.
• Identify payer reimbursement discrepancies and underpayments.
• Communicate with insurance companies, patients, referring providers, and other healthcare organizations as necessary.
• Document all collection and follow-up activity accurately in eClinicalWorks (eCW).
• Maintain organized and timely follow-up on assigned accounts.
• Assist with patient account questions and balances when necessary.
• Maintain patient confidentiality and comply with HIPAA requirements.
• Work collaboratively with billing, front office, clinical staff, providers, and administration to resolve revenue cycle issues.

Qualifications & Requirements

• Bilingual in English and Spanish required.
• Previous medical billing or healthcare accounts receivable experience required.
• Experience working insurance A/R, claim denials, appeals, and payment discrepancies strongly preferred.
• Strong understanding of Medicare, Medicare Advantage, PPO, POS, HMO, and commercial insurance plans.
• Working knowledge of CPT coding, ICD-10-CM, and medical terminology.
• Understanding of EOBs, ERAs, claim adjustments, denial codes, and payer correspondence.
• Experience using insurance payer portals and websites.
• eClinicalWorks (eCW) experience preferred.
• Orthopedic or specialty medical billing experience is a plus.
• Strong computer and data-entry skills.
• Excellent telephone and written communication skills.
• Strong organizational, analytical, and problem-solving skills.
• High attention to detail and accuracy.
• Ability to independently research an unpaid claim and take it through resolution.
• Ability to prioritize high-dollar and aging accounts in a fast-paced environment.
• Must be dependable, accountable, and able to meet A/R follow-up expectations.
• Must be willing to work as part of a team.

Benefits

• 401(k)
• 401(k) matching
• Paid time off

Compensation

$17.50–$19.00 per hour, based on experience.

Schedule

Monday through Friday

Work Location

In person

Pay: $16.50 - $18.00 per hour

Benefits:

• 401(k)
• Paid time off

Work Location: In person