United States onlyGuided by our organizational values, we collaborate closely with world-class surgeons and other partners to improve people’s quality of life. At Orthofix, we want team members who build relationships and share knowledge, challenge the status quo, and deliver results every day to help us achieve our vision to be the unrivaled partner in Med Tech.
Requirements
- Independently manage a portfolio of high-priority and complex claims requiring advanced solutions and strategies.
- Analyze denials, overpayments and underpayments to determine root cause; execute appropriate action plans including appeals, escalations and payer outreach.
- Submit technical, clinical and medical necessity appeals at all levels (including external reviews) with supporting documentation.
- Research payer contract language, LCD/NCD guidelines and policy updates; apply findings to claims resolution and communicate relevant changes to peers and leadership.
- Identify payer trends (example, systemic rejections, denials, overpayments or underpayments) and escalate issues with supporting data to payer contacts and leadership.
- Resolve escalated issues involving prepay audits, refund requests, rebills, recoupments and coordination of benefits discrepancies.
- Manage HCFA returns and claim corrections, ensuring clean resubmission per billing guidelines.
- Communicate effectively with leadership and cross-functional teams to resolve multifaceted claim barriers.
- Ensure account documentation is accurate, detailed, and audit ready across all internal system.
- Consistently meet or exceed departmental metrics related to productivity, quality, aging resolution, and cash recovery.
Benefits
- 401k Matching
- Retirement Plan
- Generous Paid Time Off
