Revenue Cycle Specialist – Orthopedic Care

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $25 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 4%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Track, analyze, and appeal payer claim denials through structured denial management workflows • Monitor payer contract performance and fee schedules to audit for underpayments • Calculate and collect up-front patient financial responsibility using real-time eligibility tools • Reconcile underpayments against payer contract fee schedules and audit high-reimbursement cases • Ensure reimbursements meet beneficiary, medical necessity, practitioner scope, and coding requirements • Determine 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 healthcare program requirements • Enhance compliance coding and billing knowledge through training • Participate in coding reviews and monitoring of coding practices • Participate in internal audits and address discrepancies with corrective actions • Stay current on coding, reimbursement, and regulatory changes • Ensure collections and accounts receivable processes comply with regulations, protect patient information, and maintain financial integrity • Maintain and enforce a billing and receivables framework that ensures compliance, accurate reimbursement, patient privacy, and optimized cash flow

🎯 Requirements

• 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) a major plus • Exceptional communication skills to interact with patients, healthcare providers, and insurance companies • Unmatched attention to detail to ensure claims are processed timely and correctly, and that payments are received • Ability to manage multiple tasks and prioritize effectively • Ability to use multiple digital tools for billing, record keeping and patient care directive • Authorized to work in the US for any employer without sponsorship