Podiatry Billing Specialist - AR, Payment Posting (Full Time, Remote)

Adelfi Medical Billing Solutions: Adelfi Medical Billing Solutions is a fully remote medical billing company serving 60+ healthcare practices across New York and New Jersey. We're looking for an experienced podiatry billing specialist to fully manage podiatry client accounts, from payment posting through AR resolution and client reporting.

Payment Posting: Post in-network and out-of-network insurance and patient payments, adjustments, and denials, including ERAs/835s, manual EOBs, paper checks, and virtual credit cards. Verify payments against contracted fee schedules and flag underpayments or incorrect contractual adjustments. Process recoupments, offsets, overpayments, and refund requests. Reconcile daily deposits to bank statements and payment batches.

Accounts Receivable & Denials: Work AR aging reports for assigned accounts, prioritizing high-dollar and timely-filing-sensitive claims. Resolve denials and prepare appeals for commercial, Medicare, Medicaid, and Managed Medicaid payers. Follow up on unpaid and underpaid claims through payer portals and phone. Monitor and work credit balances.

Podiatry-Specific Expertise: Apply routine foot care rules correctly, including Medicare class findings and Q7/Q8/Q9 modifiers, qualifying systemic conditions, and frequency limitations. Use podiatry modifiers accurately, including TA and T1-T9 toe modifiers, AT/GA/GY/GZ, and 59/XS.Bill nail debridement, callus and corn paring, and related services (11720/11721, G0127, 11055-11057) in line with payer policy. Handle wound care and debridement billing (11042-11047, 97597/97598), along with documentation requirements. Manage DME billing for custom orthotics, diabetic shoes and inserts (A5500-A5513), and CROW walkers, including the certifying physician statement and supplier documentation. Apply surgical global periods and bill bunionectomy, hammertoe, and other foot and ankle surgical procedures correctly. Use ABNs appropriately for non-covered and frequency-limited services.

Requirements: 3+ years of podiatry billing experience, covering both AR and payment posting. Proven experience managing client accounts end to end. Strong knowledge of Medicare routine foot care LCDs, podiatry modifiers, and DME documentation rules. Experience with in-network and out-of-network payment posting. Ability to read complex EOBs, ERAs, and CARC/RARC codes. Experience with commercial, Medicare, Medicaid, and Managed Medicaid payers in NY/NJ.Clear, professional communication with providers and practice staff. Highly organized, able to manage multiple accounts and deadlines independently. Reliable internet connection and a private, HIPAA-compliant workspace.

Preferrede: ClinicalWorks (ECW) experience. CPC, CPB, or similar certification. Familiarity with the No Surprises Act and out-of-network workflows. Proficiency in Excel for AR and collections reporting.