Billing Specialist - Surgery Center (Administrative)
Excelsior Orthopaedics is a multi-specialty orthopedic practice that has been providing comprehensive care since 2002. We have multiple locations throughout the Western New York region and a free-standing ambulatory surgery center, Buffalo Surgery Center. Excelsior Orthopaedics offers a suite of in-house services including general orthopaedic evaluation and treatment, podiatry, physical & occupational therapy, nutrition counseling, sports training, outreach athletic training, orthopaedic express care, imaging, durable medical equipment, and an outpatient total joint program. Buffalo Surgery Center provides surgical and procedural treatments for orthopaedic, pain and spine, podiatry, total joint replacement, and gastrointestinal patients. Our mission is to transform the lives of our patients by restoring function and enhancing quality of life. We are committed to innovative care that is driven by patient needs and supported by the most skilled, experienced team in Western New York.
This role offers is a hybrid position*
Job Summary
We are seeking a detail-oriented and experienced Surgery Center Billing Specialist to join our team. The Billing Specialist will be responsible for handling all aspects of billing and collections for the surgery center. This includes ensuring accurate and timely submission of claims to insurance companies, processing patient billing, and following up on outstanding accounts to ensure proper reimbursement for services provided.
Duties and Responsibilities
- Accurately and timely submit insurance claims for surgery center services, including outpatient procedures, consultations, and other services provided.
- Ensure all claims are submitted in accordance with insurance policies, protocols, and coding requirements.
- Ensure patient insurance information and eligibility accurately obtained.
- Process patient statements and follow up on outstanding patient balances, including answering patient billing inquiries and resolving billing discrepancies.
- Work closely with insurance companies to resolve denied claims, underpayments, and other payment issues.
- Track, research, and reconcile patient and insurance accounts to ensure accurate billing and collections.
- Maintain up-to-date knowledge of insurance regulations, payer-specific requirements, and industry best practices.
- Coordinate with clinical staff, management, and external vendors to ensure smooth billing and claims processing.
- Prepare and maintain detailed reports of billing activity, outstanding balances, and revenue cycle performance.
- Ensure compliance with all applicable healthcare billing regulations, including HIPAA and other relevant federal and state laws.
Requirements and Qualifications
- High school diploma or equivalent required; additional certification in medical billing or coding preferred (e.g., CPC, CCS).
- Minimum of 2-3 years of experience in medical billing, preferably in a surgery center or outpatient facility.
- Strong understanding of healthcare insurance, CPT, ICD-10, and HCPCS coding.
- Experience with electronic health record (EHR) and practice management software (e.g., Epic, Kareo, AdvancedMD).
- Excellent communication skills with the ability to effectively interact with insurance providers, patients, and staff.
- Strong attention to detail, organizational skills, and the ability to manage multiple tasks simultaneously.
- Knowledge of medical terminology and an understanding of the surgical procedures performed at the center.
- Experience with surgery center billing and revenue cycle management.
- Familiarity with government payer programs (Medicare, Medicaid) and commercial insurance plans.
- Ability to work independently, take initiative, and troubleshoot billing issues.
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.
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.
We offer a comprehensive benefits package that includes health (with employer contribution), dental, and vision insurance, employer paid base life, and other voluntary benefits*. Time off benefits include paid combined time off (CTO) and seven paid holidays, plus a floating holiday after one year of service. Retirement benefits include a 401(k) with company contribution and profit sharing after one year of service. Qualified team members become eligible to participate in medical benefits on the 1st of the month following date of hire, and retirement benefits after 90 days.
We also provide professional development opportunities, flexible work schedules, wellness incentives, healthy vending options, and relaxed dress code on Fridays. Our community-focused culture encourages participation in local events, fundraisers, and causes chosen by our team. We are committed to providing our employees with the resources they need to thrive both personally and professionally.
*Other voluntary benefits include Voluntary Short Term Disability, Long Term Disability, Critical Illness, Accident Insurance, Supplemental Life Insurance, and legal and identity protection and pet insurance.
