Medical Biller (Part-time to Start) (Orthopedic)

This is a remote position.

Job Summary

RCM Staff BPO is hiring a part-time Medical Billing and Prior Authorization Specialist to support an orthopedic spine surgery practice.

The specialist will handle prior authorizations for surgical cases, verify eligibility and benefits, submit claims, work denials and A/R, and post payments for a single-provider practice. The specialist is responsible for getting clean claims out, authorizations approved before the case, and denied or unpaid claims resolved. This role requires hands-on orthopedic or spine billing experience and strong follow-through, such as strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.

Requirements

Qualifications

* 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

Preferred Qualifications

* Experience supporting spine surgery, orthopedic surgery, or pain management practices

* Experience with surgical prior authorizations through delegated review vendors such as Carelon or eviCore

* Experience with workers' compensation billing and authorization

* Understanding of surgical global periods, modifiers, and add-on codes for spine procedures

* Familiarity with Georgia insurance plans, including Medicare (Palmetto GBA), Georgia Medicaid and CMOs, and TRICARE East

* Willingness to learn a new EHR and practice management system, as the practice is implementing a new platform

Schedule

* Part-time position for 90 days, approximately 20 hours per week (4 hours per day), with the possibility of moving to full-time after

* Must be available during Eastern Time business hours

* Final schedule will be determined based on practice needs