Billing Specialist

Who we are: 

Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Headquartered in Stamford, Connecticut, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts. 

What you’ll do: 

Responsibilities/Duties:

• Perform accurate and timely charge entry for multiple divisions.
• Review charges for completeness, coding accuracy, and payer-specific requirements.
• Monitor and manage billing work queues to ensure claims are processed within established timelines.
• Identify, research, and resolve claim edits, rejections, and billing exceptions.
• Collaborate with an outsourced billing vendor to ensure claims are billed correctly and follow-up activities are completed timely.
• Track vendor performance and escalate billing issues when necessary.
• Utilize Excel to analyze billing data, identify trends, and reconcile reports.
• Work closely with coding, front-end, and clinical teams to resolve billing discrepancies.
• Assist with process improvement initiatives and workflow optimization.
• Maintain compliance with payer guidelines, regulatory requirements, and company policies.

Who you are:

Qualifications:

• Minimum 2 years of medical billing experience required.
• Strong understanding of CPT, ICD-10, HCPCS, modifiers, and insurance billing guidelines.
• Experience with charge entry, claim submission, and revenue cycle workflows.
• Proficiency in Microsoft Excel, including Pivot Tables, VLOOKUP/XLOOKUP, filtering, and data analysis.
• Experience working with outsourced billing vendors preferred.
• Knowledge of Medicare, Medicaid, Commercial billing preferred.
• Experience with Modernizing Medicine (ModMed) Practice Management and EMR systems is strongly preferred.

Skills & Competencies

• Exceptional attention to detail and accuracy.
• Strong analytical and problem-solving skills.
• Ability to prioritize and manage multiple tasks simultaneously.
• Excellent communication and interpersonal skills.
• Self-motivated with the ability to work independently and as part of a collaborative team.
• Comfortable working in a high-volume, fast-paced healthcare environment.

What we offer: 

• Excellent growth and advancement opportunities 
• Dynamic environment 
• Access to a diverse network of practitioners 
• Broad infrastructure of tools and programs to enhance the employee experience    
• Competitive Compensation 
• Generous PTO  
• Benefits package: health, dental, vision, 401(k), etc. 

We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”).