Medical Billing Specialist – Orthopedic Care

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Icon Health

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

🤖 Artificial Intelligence

⚕️ Healthcare Insurance

Healthcare • Artificial Intelligence • Healthcare Insurance

Icon Health is a value-based musculoskeletal (MSK) and orthopedic care company that partners with health plans, value-based care organizations, providers, and patients to deliver full-risk, end-to-end orthopedic services. It combines virtual and in-person access to orthopedic clinicians, a national network of aligned providers and facilities, and AI-powered predictive outreach and data-driven provider-efficiency scoring to lower orthopedic spend, improve outcomes (including HEDIS performance), and accelerate patient recovery.

📋 Description

• Ensure medical services and supplies are reimbursed only when provided to qualified beneficiaries, medically reasonable and necessary, performed within the practitioner's scope, and accurately coded against the medical record • Identify root causes of billing errors, prevent recurrence, retrain on coding practices, and review policies and procedures • Provide timely overpayment refunds to payors in compliance with federal or state-funded healthcare program requirements • Maintain current compliance coding and billing knowledge and participate in training • Participate in coding reviews and monitor coding practices • Participate in internal audits, verify billing updates across claims, and address discrepancies with corrective actions • Track coding, reimbursement, and regulatory changes to support accurate claims, compliance, and revenue management • Ensure collections and accounts receivable processes comply with regulations, protect patient information, and maintain financial integrity • Maintain and enforce a compliant billing and receivables framework that ensures accurate reimbursement, protects patient privacy, and optimizes cash flow

🎯 Requirements

• Deep expertise in claim submission, copays, payment posting, insurance guidelines, and revenue cycle workflows • Degree, certificate, or diploma in medical billing, health information management, or healthcare administration preferred • Completion of a medical billing training program preferred • Certified Professional Biller (CPB) is a major plus • Exceptional communication skills for interacting with patients, healthcare providers, and insurance companies • Exceptional attention to detail for timely and accurate claim processing and payment receipt • Ability to manage multiple tasks and prioritize effectively • Ability to use multiple digital tools for billing, record keeping, and patient care directives • Authorization to work in the US for any employer without sponsorship