Job description
This is a remote position.
Job Summary
RCM Staff BPO is hiring a part-time Medical Billing and Prior Authorization Specialist to support an orthopedic spine surgery practice.
The specialist will handle prior authorizations for surgical cases, verify eligibility and benefits, submit claims, work denials and A/R, and post payments for a single-provider practice. The specialist is responsible for getting clean claims out, authorizations approved before the case, and denied or unpaid claims resolved. This role requires hands-on orthopedic or spine billing experience and strong follow-through, such as strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.
Requirements
Qualifications
At least 2 years of experience with U.S. healthcare insurance
Hands-on medical billing experience for an orthopedic or spine surgery practice, including prior authorizations for surgical procedures
Familiarity with commercial insurance and government health plans
Experience using payer portals and insurance websites
Strong written and spoken English, including comfort speaking with payers and patients by phone
Excellent attention to detail and follow-up skills
Ability to work independently and manage multiple patient accounts
Reliable internet connection and a suitable remote workspace
Preferred Qualifications
Experience supporting spine surgery, orthopedic surgery, or pain management practices
Experience with surgical prior authorizations through delegated review vendors such as Carelon or eviCore
Experience with workers' compensation billing and authorization
Understanding of surgical global periods, modifiers, and add-on codes for spine procedures
Familiarity with Georgia insurance plans, including Medicare (Palmetto GBA), Georgia Medicaid and CMOs, and TRICARE East
Willingness to learn a new EHR and practice management system, as the practice is implementing a new platform
Schedule
Part-time position for 90 days, approximately 20 hours per week (4 hours per day), with the possibility of moving to full-time after
Must be available during Eastern Time business hours
Final schedule will be determined based on practice needs
Originally posted on Himalayas
Who can apply
Eligible countries: United States. Accepted UTC offsets: UTC-10, UTC-9, UTC-8, UTC-7, UTC-6, UTC-5, UTC+14. Review the full description for employer-specific work authorization, residency and schedule requirements.