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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing and prior authorizations specifically for orthopedic and spine surgery practices, with a strong focus on managing patient accounts and resolving claims efficiently. Proficient in communicating with payers and patients, ensuring compliance with U.S. healthcare insurance standards.
Highest-signal resume keywords
Medical Billing ExperiencePrior Authorizations for Surgical ProceduresExperience with Payer PortalsStrong Written and Spoken EnglishAttention to Detail
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Prior AuthorizationsClaims SubmissionDenial ManagementAccounts ReceivableSurgical BillingWorkers' Compensation BillingUnderstanding of ModifiersSurgical Global PeriodsInsurance VerificationPatient Eligibility Verification
Soft Skills
Excellent CommunicationIndependent WorkFollow-Up SkillsAttention to DetailTime Management
Tools & Technologies
Payer PortalsInsurance WebsitesEHR SystemsPractice Management Systems
Industry Keywords
U.S. Healthcare InsuranceOrthopedic SurgerySpine SurgeryGeorgia Insurance PlansMedicareGeorgia MedicaidTRICARE EastCommercial InsuranceGovernment Health PlansPain Management
About the role
Key responsibilities & impact- Handle prior authorizations for surgical cases
- Verify patient eligibility and benefits
- Submit claims and ensure clean claims are sent
- Work denials and accounts receivable
- Post payments
- Obtain authorization approval before surgical cases
- Resolve denied or unpaid claims
- Support a single-provider orthopedic spine surgery practice
- Manage multiple patient accounts independently
- Communicate with payers and patients by phone
Requirements
What you’ll need- 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
- Must be available during Eastern Time business hours
- Preferred: Experience supporting spine surgery, orthopedic surgery, or pain management practices
- Preferred: Experience with surgical prior authorizations through delegated review vendors such as Carelon or eviCore
- Preferred: Experience with workers' compensation billing and authorization
- Preferred: Understanding of surgical global periods, modifiers, and add-on codes for spine procedures
- Preferred: Familiarity with Georgia insurance plans, including Medicare (Palmetto GBA), Georgia Medicaid and CMOs, and TRICARE East
- Preferred: Willingness to learn a new EHR and practice management system
Benefits
Comp & perks- Part-time position for 90 days, approximately 20 hours per week (4 hours per day), with the possibility of moving to full-time after
- Remote work arrangement
- Opportunity to learn a new EHR and practice management system