Orthotics & Prosthetics Billing Specialist
Medical Billing & Coding
Company Overview
Shriners Children's is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.
With 20+ hospitals, outpatient clinics, ambulatory care centers and outreach locations across the globe, we provide excellent care to children up to age 18 regardless of their family's ability to pay or insurance status. Please click here to learn more about our locations.
Job Description
The Orthotics & Prosthetics Billing Specialist is responsible for Orthotics & Prosthetics (O&P) billing, processing of EOB's, processing statements, posting of payments (including batch payments), reconciling of payments to the appropriate ledgers, following up on submitted claims, monitoring unpaid claims, initiating tracers, resubmitting claims as necessary, and assisting with appeals processing. This position is also responsible for researching and responding by telephone and in writing to all patient and payer inquiries regarding billing issues and problems, as well as understanding any technology applications utilized for O&P Billing. The person in this role will be responsible for working in conjunction with other departments to ensure the accuracy of the Billing Tool through periodic audits.
Key Responsibilities:
Required Qualifications:
Preferred Qualifications:
Shriners Children's is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.
With 20+ hospitals, outpatient clinics, ambulatory care centers and outreach locations across the globe, we provide excellent care to children up to age 18 regardless of their family's ability to pay or insurance status. Please click here to learn more about our locations.
Job Description
The Orthotics & Prosthetics Billing Specialist is responsible for Orthotics & Prosthetics (O&P) billing, processing of EOB's, processing statements, posting of payments (including batch payments), reconciling of payments to the appropriate ledgers, following up on submitted claims, monitoring unpaid claims, initiating tracers, resubmitting claims as necessary, and assisting with appeals processing. This position is also responsible for researching and responding by telephone and in writing to all patient and payer inquiries regarding billing issues and problems, as well as understanding any technology applications utilized for O&P Billing. The person in this role will be responsible for working in conjunction with other departments to ensure the accuracy of the Billing Tool through periodic audits.
Key Responsibilities:
- Processes O&P Billing to third party payers and patients; maintaining supporting documentation files.
- Processes patient statements, keys data, posts transactions, and verifies accuracy of input to reports generated.
- researches and responds to all patient and/or payer inquiries regarding O&P billing issues and problems. Refers all patient related issues and concerns to the office that patient was seen and (when necessary) to the practitioner who provided the care..
- Follows up on all submitted claims, monitors unpaid claims, initiates tracers, and resubmits claims, as needed.
- Will receive third party reimbursements and will post and reconcile payments to patient accounts.
- Balance daily batch payments and reports.
- Maintains payer and patient demographic information and data collection.
- Under the direction of the O&P Billing Supervisor and Director of O&P will assist with the development of organization procedures and update of forms and manuals pertaining to billing of O&P devices.
- May assist (pending detailed direction of Legal and the O&P Billing Supervisor) in preparing documentation and responses for legal inquires and litigation,.
- Ensures strict confidentiality of patient and financial records according to all SHC Policies and Procedures.
- Work collaboratively and closely with management, executives, hospitals, staff and leadership to ensure effective and compliant O&P Billing.
- This position will be responsible for the tasks outlined above with the understanding that the position must demonstrate flexibility to perform job functions, tasks and projects in an evolving organizational landscape at the direction of the National Director of Orthotics & Prosthetics.
Required Qualifications:
- 3 yrs of healthcare billing, claims and insurance experience
- Knowledge of insurance EOB's
- Experience interacting with patients and providers via phone and email in a courteous and professional manner
- Strong oral and written communication skills
Preferred Qualifications:
- 3 yrs of DME or O&P billing insurance experience