Key Responsibilities:

• Accurately prepare and submit claims for orthopedic procedures, imaging, injections, and primary care visits using HCFA (CMS-1500) claims forms both electronically and on paper as needed.
• Verify insurance eligibility and benefits before services are rendered.
• Review clinical documentation and assign appropriate CPT, ICD-10, and HCPCS codes.
•  Post insurance and patient payments, adjustments, and denials in billing software.
•  Monitor aging reports and follow up on unpaid or denied insurance claims.
•  Initiate and manage collection efforts for outstanding patient balances, including sending statements, calling patients, and arranging payment plans.
• Resolve patient billing questions and disputes in a professional and compassionate manner.
•  Identify trends in denials or non-payment and escalate issues to management or providers as needed.
• Maintain accurate records of collection activities and comply with all collection regulations.
• Ensure compliance with HIPAA, federal, state, and payer-specific billing rules.

Qualifications:

• High school diploma or equivalent required; associate degree or billing certification preferred.
• 1-2 years of medical billing and collections experience in orthopedic or family practice clinic.
• Knowledge of CPT/ICD-10 coding for musculoskeletal procedures, injections, preventive care, and chronic disease management.
• Familiarity with EHR and billing systems.
• Strong understanding of payer reimbursement guidelines, including Medicare, Medicaid, and commercial insurance.
• Excellent organizational, problem-solving, and follow-up skills.
• Professional and empathetic communication skills.

Coquille Valley Hospital provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Coquille Valley Hospital complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Coquille Valley Hospital expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Coquille Valley Hospital’s employees to perform their job duties may result in discipline up to and including discharge.