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Excelsior Orthopaedics

Billing Specialist - Outpatient

Posted 7 Days Ago
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In-Office
14226, Amherst, NY
20-36 Hourly
Junior
In-Office
14226, Amherst, NY
20-36 Hourly
Junior
Reviews clinical documentation, assigns orthopedic diagnosis and procedure codes, and manages ASC surgical billing from claim creation through payment resolution. Monitors denials, rejections, and edits; supports appeals, audits, documentation clarification, and revenue cycle improvements. Provides billing assistance to patients, providers, staff, and vendors while maintaining compliance with CMS guidelines, payer policies, and ASC coding regulations.
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Job Summary


We are seeking a detail-oriented and experienced Biller to join our Ambulatory Surgery Center (ASC) team.  The ideal candidate has strong knowledge of orthopedic coding, ASC-specific billing practices, and payer regulations.


Duties and Responsibilities


  • Demonstrate our core values of being patient centered, team focused, service driven, accountable, and innovative every day.
  • Accurately review and abstract information from operative and clinical documentation to assign appropriate diagnosis and procedure codes for surgical cases.
  • Ensure coding and billing practices comply with CMS guidelines, payer policies, and ASC-specific coding regulations.
  • Manage billing functions for surgical procedures, including claim creation, submission, and follow-up for payment resolution.
  • Communicate with providers and team members to clarify documentation and ensure code accuracy.
  • Monitor and respond to coding-related denials, rejections, and edits; assist with appeals and identify areas for process improvement.
  • Collaborate with the billing team and other departments to resolve discrepancies and optimize revenue cycle performance.
  • Participate in internal audits, meet coding accuracy benchmarks, and stay current with coding regulations, payer updates, and orthopedic-specific policies.
  • Answer incoming phone calls regarding billing and coding inquiries from patients, providers, team members, and external vendors, delivering clear, courteous, and professional assistance.
  • Evolve in your role when performing supplemental responsibilities as assigned.
Qualifications

Requirements and Qualifications


  • High School diploma or GED required; Associate degree preferred.
  • Minimum of 1 year of experience in medical billing, preferably in an orthopedic or ASC setting.
  • Familiarity with EHR/EMR systems and coding software; experience with SIS or Waystar is a plus.
  • Strong knowledge of medical terminology related to orthopedics, physical therapy, and podiatry preferred.
  • Excellent communication, organizational, and analytical skills.
  • Ability to work independently while contributing to a collaborative team environment.
  • Computer skills required with minimum proficiency in Microsoft Word, Excel, Outlook, and Teams.

Physical Demands


  • Manual and finger dexterity and eye-hand coordination to enter data and operate office equipment
  • Corrected vision and hearing within normal range to observe and communicate with patients, providers, and staff.
  • Frequently remaining in a stationary position, often sitting for prolonged periods working on a computer, telephone, copy/fax machine, and other office equipment
  • Occasional standing and walking required
  • Occasional lifting and carrying items weighing up to 10 pounds.

The pay range for this position is determined based on several factors, including the candidate’s years of experience, qualifications, training, licenses, designations, and the overall market conditions.

 

This job description does not state or imply that the duties and responsibilities listed are the only ones required of this position.  Team members in this role will be required to perform other job-related duties at the discretion of the employer and may have additional duties assigned as necessary.  

 

Excelsior Orthopaedics and Buffalo Surgery Center are committed to the full inclusion of all applicants.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. 

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