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Medical Billing and Collections Representative (Commercial)

Date Posted: Jun 23, 2026
Yearly: USD - USD
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Job Detail

  • location_on
    Location Clifton Springs, New Jersey, United States of America
  • desktop_windows
    Job Type: Permanent
  • schedule
    Shift:
  • analytics
    Career Level:
  • group
    Positions:
  • calendar_view_day
    Experience:
  • male
    Gender: No Preference
  • school
    Degree:
  • calendar_month
    Apply Before: Sep 21, 2026
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Job Description

Overview

The Medical Billing & Collections Representative at Progressive Spine and Orthopaedics LLC is responsible for the entire billing and collections process for medical claims, focusing on commercial insurance and out-of-network reimbursements. This role requires strong analytical, negotiation, and communication skills to ensure accurate claim submissions and timely payments, particularly for surgical services such as Neuro Spine Surgery, Orthopaedics, and Podiatry.

Key responsibilities

  • Monitor and follow up on unpaid or underpaid claims from commercial and out-of-network carriers.
  • Communicate with insurance carriers, providers, and patients for claim resolution.
  • Research and appeal denials, including complex procedure denials.
  • Collaborate with teams to verify accurate coding and claim documentation.
  • Negotiate reimbursements with insurance carriers for high-cost surgeries.
  • Provide clear explanations of patient statements and billing-related queries.
  • Maintain records of billing and collection activities.
  • Generate reports on outstanding claims and payment trends.
  • Reconcile received payments against submitted claims.
  • Process adjustments, refunds, and write-offs as per policies.

Required skills

  • 3-5 years of medical billing and collections experience
  • Experience specializing in commercial insurance and out-of-network billing
  • Knowledge of Neuro Spine, Orthopedic, or Podiatry billing
  • Strong understanding of ICD-10, CPT, and HCPCS coding
  • In-depth knowledge of out-of-network reimbursement structures
  • Experience with medical billing and EHR/claims management software
  • Proficient in MS Excel and reporting tools
  • Knowledge of HIPAA compliance
  • Excellent written and verbal communication skills
  • Strong negotiation and conflict-resolution skills
  • Analytical and detail-oriented problem-solving skills

What the company offers

Not specified in the original listing.

Skills Required

Company Overview

Progressive Spine and Orthopaedics LLC
Clifton Springs, New Jersey, United States of America
6 Current Jobs Openings

Progressive Spine and Orthopaedics LLC specializes in providing comprehensive care for patients with spinal and orthopedic conditions. They focus on personal injury treatments, assisting patients through their medical claims process. Read More

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