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Orthofix
Orthofix
1,001 – 5,000 Employees
H1B Visa SponsorConsultingHealthcareLogistics
Orthofix develops medical devices and therapies for spinal and orthopedic conditions. Its products include biologics, bone growth stimulation technologies, and surgical tools designed to support treatment of bone and soft tissue conditions and help improve patient mobility. The company’s work spans product development and clinical research, with teams focused on advancing care in the medical device sector.
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Remote Health Claims Collections Specialist II

Resolve complex medical equipment and orthopedic claims for Orthofix, a medical technology company. Handle appeals, payer escalations, denials, and revenue recovery.

USUnited States
$23 – $30 / hour
RemoteFull-timeJuniorMiddleNo degree requiredEnglish RequiredCollections
Oracle

Description

  • Manage a portfolio of high-priority, complex claims and develop advanced resolution strategies.
  • Investigate denials, overpayments, and underpayments; determine root causes and pursue resolution through appeals, escalations, and payer outreach.
  • Prepare and submit technical, clinical, and medical necessity appeals at every level, including external reviews, with supporting documentation.
  • Review payer contracts, LCD/NCD guidance, and policy updates; apply findings to claims and share relevant changes with colleagues and leadership.
  • Track payer patterns such as systemic rejections, denials, and payment errors, and escalate evidence-based findings to payers and leadership.
  • Address escalated prepayment audits, refund requests, rebilling, recoupments, and coordination of benefits discrepancies.
  • Correct returned HCFA claims and resubmit them in accordance with billing guidelines.
  • Work with leaders and cross-functional teams to remove complex barriers to claim resolution.
  • Maintain complete, accurate, audit-ready account records in internal systems.
  • Achieve departmental targets for productivity, quality, aging resolution, and cash recovery.
  • Guide junior collectors as a subject matter resource and support leadership efforts to improve payer compliance and revenue recovery.

Requirements

  • High school diploma or equivalent experience.
  • At least two years of medical collections or revenue cycle experience, focused on post-billing DME or orthopedic claims.
  • Advanced understanding of payer guidelines, revenue cycle management, and appeals for Medicare, Medicare Advantage, Medicaid, and commercial insurers.
  • Able to read and interpret EOBs, payer policies, LCDs, and prior authorization requirements.
  • Strong working knowledge of ICD-10, HCPCS, and CMS-1500 billing procedures.
  • Proficiency with Microsoft Office and medical billing platforms.
  • Demonstrated experience handling complex denials, payer escalations, and appeals at all levels.
  • Strong attention to detail and ability to identify trends and implement corrective strategies.
  • Excellent communication and negotiation skills with payers and internal stakeholders.
  • Able to work independently with accuracy, strong time management, and compliance in mind.
  • Familiarity with Oracle or comparable revenue cycle platforms.
  • Associate degree preferred.

Benefits

  • Bonus
  • Benefits
  • Equal employment opportunities
  • Reasonable accommodations for qualified individuals with disabilities

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