Medical Billing and Collections Specialist

Medical Billing & Collections Specialist

Capital Orthopaedics + Spine — Palm Beach Gardens, FL

About Us:

At Capital Orthopaedics + Spine, we deliver concierge-level, white-glove care in orthopaedic and spine medicine. Located in Palm Beach Gardens, with satellite offices in Jupiter, West Palm Beach, and Aventura, our private practice is known for its precision, compassion, and highly personalized patient experience.

Behind every exceptional patient encounter is a strong administrative and billing team ensuring that claims are processed accurately and payments are collected appropriately. We are seeking an experienced Medical Billing & Collections Specialist who takes pride in navigating the complexities of healthcare reimbursement with diligence, professionalism, and persistence.

Position Overview:

The Medical Billing & Collections Specialist plays a vital role in maintaining the financial health of our practice. This position focuses primarily on accounts receivable management, insurance follow-up, denial resolution, and claims support.

This individual will work closely with practice leadership and our clinical team to ensure claims are processed efficiently, reimbursement is maximized, and outstanding balances are addressed in a timely and professional manner.

We are looking for someone who is detail-oriented, proactive, and solutions-driven, with the confidence to independently investigate claims issues while also collaborating with leadership when needed.

Key Responsibilities:

• Manage accounts receivable follow-up with commercial insurers, Medicare, and other payers
• Investigate and resolve insurance denials, underpayments, and claim rejections
• Submit and track appeals and supporting documentation to insurance carriers
• Review and interpret Explanation of Benefits (EOBs) and payer correspondence
• Communicate with insurance representatives to resolve payment discrepancies
• Monitor aging reports and prioritize accounts requiring follow-up
• Navigate payer portals such as Availity to research claim status and submit inquiries
• Verify patient insurance benefits, including copay, deductible, coinsurance, and referral requirements when needed
• Calculate and reconcile payment breakdowns, percentages, and patient responsibility amounts
• Maintain accurate documentation within the EMR and billing system
• Assist with outgoing billing and mailing of claims when needed
• Collaborate with the front office and clinical teams to ensure accurate claim submission
• Identify opportunities to improve billing workflows and reimbursement processes

Qualifications:

• 3+ years of experience in medical billing, accounts receivable, or insurance collections
• Strong experience handling insurance denials and appeals
• Proficiency navigating payer portals such as Availity
• Ability to interpret EOBs, insurance policies, and reimbursement guidelines
• Solid understanding of CPT codes, ICD-10 coding, and medical terminology
• Knowledge of insurance benefits including copays, deductibles, coinsurance, and referrals
• Strong analytical and math skills for payment calculations and reconciliation
• Excellent written and verbal communication skills when interacting with payers and internal teams
• Detail-oriented, organized, and comfortable working independently
• Orthopaedic, urgent care, or primary care billing experience strongly preferred

Schedule & Work Environment

• Part-Time or Full-Time (Flexible Schedule Available)
• Monday – Friday
• Approximately 30–40 hours per week
• In-person position located in Palm Beach Gardens, FL
• W-2 employee status
• Compensation commensurate with experience

Our Culture:

Our practice operates with a high level of professionalism, accountability, and collaboration. We are an all-hands-on-deck team that supports one another to ensure both operational excellence and exceptional patient care.

We value team members who are resourceful, communicative, and motivated to continuously improve the systems around them.

Pay: From $18.50 per hour

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• Medical billing: 3 years (Preferred)

License/Certification:

• Medical Billing Certification (Preferred)

Ability to Commute:

• Palm Beach Gardens, FL 33410 (Preferred)

Work Location: In person