Proliance Surgeons

Role Description We are seeking a detail-oriented and analytical Revenue Cycle Coding Denial Specialist (Remote) to join our team. This role plays a key part in identifying denial trends, supporting Accounts Receivable (AR) workflows, and driving resolution through research, coding review, and appeal preparation. The ideal candidate brings strong coding expertise, sharp critical thinking skills, and a solid understanding of the full-billing and reimbursement lifecycle. This position also serves as a coding float, providing flexible support and coverage across coding teams as needed. Must have an active CPC certification with credentialing from AHIMA and/or AAPC. Schedule: Full-time, Monday - Friday. Must live in one of the following states or be willing to relocate to: WA, ID, FL, NC, AZ, OH, OR, TN, TX, or RI. Key Duties and Responsibilities - Review and analyze denied claims to determine root cause and appropriate resolution - Identify denial trends and collaborate with coding, billing, and AR teams to improve outcomes - Prepare and submit detailed, compliant appeal letters with supporting documentation - Perform coding reviews to ensure accuracy and alignment with payer guidelines, CPT, ICD-10-CM, and HCPCS standards - Partner with AR team members to resolve complex accounts and reduce aging receivables - Communicate with providers and staff to obtain necessary documentation or clarification - Assist with education and feedback to coding and billing staff based on denial findings - Maintain up-to-date knowledge of payer policies, regulatory requirements, and coding updates - Provide coding support across specialties as needed in a float capacity - Participate in process improvement initiatives to enhance revenue cycle performance - Demonstrates appropriate utilization of coding software and coding reference material - Follow up with providers on any documentation that is insufficient, missing, or unclear - Assist providers with questions regarding coding and documentation guidelines - Provide ongoing feedback based on observations from coding documentation and identify opportunities for education and communicate trends to leaders - Keep up to date on carrier policies/guidelines to ensure all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or Payer-specific guidelines Qualifications - Minimum 3 years of coding/medical billing experience - Active CPC certification with credentialing from AHIMA and/or AAPC, must be maintained annually - ICD10 certified and/or extensive work experience - Strong understanding of medical terminology, anatomy, and physiology - Experience with denial management, AR workflows, and appeals - Orthopedic coding experience strongly preferred - Experience with NextGen and SIS systems preferred Knowledge, Skills and Abilities - A strong understanding of physiology, medical terms, and anatomy - Thorough attention to detail - Excellent written and verbal communication skills - Self-motivated team player able to multi-task and prioritize - Excellent organization and interpersonal communication skills - Strong computer skills - Experience with Microsoft Excel, Outlook, and Adobe - Working experience navigating EHR’s to abstract documentation Work Environment/Physical Demands The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions. - Work may be performed in a remote office and clinical environment - Requires corrected vision and hearing to normal range - While performing the duties of this job, the associate is regularly required to talk or hear - The associate is required to sit for long periods of time, stand and walk, bend and stretch - Use of telephone and computer is required - Manual dexterity required for use of computer keyboard - Occasionally lifts and carries items weighing up to 40 pounds - May require working under stressful conditions or working irregular hours

Role Description The role of the Revenue Cycle Specialist is a valued member of our Revenue Cycle team. As a Revenue Cycle Specialist, you will work remotely and be responsible for overseeing bill processes including: - Charge entry - Billing - Claims - Patient AR - Insurance AR You will also post payments, handle credit resolutions, along with other revenue cycle functions. Location: Proliance Edmonds Orthopedic Center Schedule: Monday - Friday, 8:00am - 5:00pm We are seeking a detail-oriented and motivated Revenue Cycle Specialist to join our Billing Office team. This role focuses primarily on managing patient statements, patient account follow-up, and resolving patient billing inquiries. The ideal candidate is organized, customer-service oriented, and experienced in healthcare billing processes. Qualifications - High School diploma or GED - Minimum 1-2 years medical billing experience - CPC or other equivalent certification - Orthopedic Coding Experience a plus - Experience with Nextgen and Amkai Billing Systems preferred Requirements - Verify information for claims is correct prior to billing - Review Surgical coding for accuracy prior to billing - Process all Primary, Secondary, and tertiary claims and address any edits or rejections - Post all patient payments - Post all Insurance and third-party payments - Credit Resolution for both Insurance and Self pay credits - Insurance AR - Patient AR - Process bad debt - Answer phones - Complete duties and assist others as directed - Must follow all policies as introduced during new teammate On-Boarding, updated real-time and outlined in Teammate Handbook Knowledge, Skills and Abilities - High level of independence, adaption, and accuracy - Ability to navigate online Payor portals and websites - Ability to effectively use Office equipment - Basic knowledge of Microsoft Office Word and Outlook - Superior customer service skills - Great interpersonal skills; demonstrating patience, composure, and cooperation; working well with all patients, physicians, and staff - Understanding of and adherence to all safety, risk management and precautionary procedures, including the consistent respect for confidentiality (HIPAA) - Using time efficiently, with meticulous attention to detail, accuracy, and completion - Ability to manage multiple factors for the best result - Resourcefulness in addressing first level problems and tenacity to see things through to solution - Ability to remove oneself personally from given situations, remaining objective - Able to adapt to change, delays or unexpected events while maintaining a positive mindset - Clear oral and written communication - Ability to provide feedback to improve performance - Self-motivated; able to work following specific guidelines and in accordance with detailed instructions; measure self against standard of excellence, overcome obstacles and challenges with little supervision Work Environment/Physical Demands The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.

Role Description The role of the Revenue Cycle specialist is a valued member of our Revenue Cycle team. As a Revenue Cycle Specialist, you will work remotely and be responsible for overseeing bill processes including: - Charge entry - Billing - Claims - Patient AR - Insurance AR - Posting payments - Handling credit resolutions - Other revenue cycle functions Schedule: Full-time, Monday - Friday, 8:00am - 4:30pm. REMOTE schedule. MUST live or be willing to relocate to any of the following states: WA, FL, NC, AZ, ID, OH, OR, TN, TX, or RI. Qualifications - High School diploma or GED - Minimum 1-2 years medical billing experience - CPC or other equivalent certification - Orthopedic Coding Experience a plus - Experience with Nextgen and Amkai Billing Systems preferred Requirements - Verify information for claims is correct prior to billing - Review Surgical coding for accuracy prior to billing - Process all Primary, Secondary, and tertiary claims and address any edits or rejections - Post all patient payments - Post all Insurance and third-party payments - Credit Resolution for both Insurance and Self pay credits - Insurance AR - Patient AR - Process bad debt - Answer phones - Complete duties and assist others as directed - Must follow all policies as introduced during new teammate On-Boarding, updated real-time and outlined in Teammate Handbook Knowledge, Skills and Abilities - High level of independence, adaption, and accuracy - Ability to navigate online Payor portals and websites - Ability to effectively use Office equipment - Basic knowledge of Microsoft Office Word and Outlook - Superior customer service skills - Great interpersonal skills; demonstrating patience, composure, and cooperation; working well with all patients, physicians, and staff - Understanding of and adherence to all safety, risk management and precautionary procedures, including the consistent respect for confidentiality (HIPAA) - Using time efficiently, with meticulous attention to detail, accuracy, and completion - Ability to manage multiple factors for the best result - Resourcefulness in addressing first level problems and tenacity to see things through to solution - Ability to remove oneself personally from given situations, remaining objective - Able to adapt to change, delays or unexpected events while maintaining a positive mindset - Clear oral and written communication - Ability to provide feedback to improve performance - Self-motivated; able to work following specific guidelines and in accordance with detailed instructions; measure self against standard of excellence, overcome obstacles and challenges with little supervision Work Environment/Physical Demands The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions. Benefits - Comprehensive and competitive benefit and pay package including health coverage - 401k with match and profit share - PTO and more!

Role Description The Patient Accounts Customer Service Representative is an integral member of the Revenue Cycle team, responsible for delivering exceptional service to patients while supporting the financial health of the organization. This remote role serves as the first point of contact for patient account inquiries, assisting patients with billing questions, payment arrangements, refunds, and account resolution. Schedule: Monday - Friday, 9am - 5:30pm PST. Key Duties and Responsibilities - Answer incoming patient phone calls in a professional, courteous, and timely manner while providing accurate information regarding billing, balances, payments, and account status. - Respond to voicemail messages and make outbound calls to patients to resolve outstanding balances, discuss account discrepancies, and assist with payment-related inquiries. - Review patient accounts for accuracy, ensuring demographic, insurance, and claim information is complete and correct prior to billing. - Process patient payments securely and accurately while maintaining compliance with organizational policies and payment handling procedures. - Manage self-pay credit balances by reviewing accounts, determining appropriate resolution, and requesting patient refunds as needed. - Perform follow-up on outstanding patient accounts receivable balances to ensure timely resolution and payment collection. - Maintain detailed and accurate account notes for all patient interactions and account activity. - Complete duties and assist others as directed. - Must follow all policies as introduced during new teammate On-Boarding, updated real-time and outlined in Teammate Handbook. Qualifications - High School diploma or GED. - Minimum 1-2 years’ experience within a medical office, healthcare billing, or revenue cycle environment required. - Experience handling high call volumes in a customer service environment preferred. - Experience with Nextgen and SIS Billing Systems a plus. - Knowledge of insurance billing, patient balances, and account reconciliation processes preferred. Requirements - Strong customer service skills with the ability to communicate empathetically and professionally with patients regarding financial matters. - Excellent verbal and written communication skills. - Knowledge of medical billing terminology, insurance processes, and patient account workflows. - Ability to work independently while following detailed instructions and established procedures. - High level of attention to detail and commitment to accuracy. - Ability to effectively use Office equipment. - Basic knowledge of Microsoft Office Word and Outlook. - Understanding of and adherence to all safety, risk management and precautionary procedures, including the consistent respect for confidentiality (HIPAA). - Using time efficiently, with meticulous attention to detail, accuracy, and completion. - Ability to manage multiple factors for the best result. - Resourcefulness in addressing first level problems and tenacity to see things through to solution. - Ability to remove oneself personally from given situations, remaining objective. - Able to adapt to change, delays or unexpected events while maintaining a positive mindset. - Clear oral and written communication. - Ability to provide feedback to improve performance. - Self-motivated; able to work following specific guidelines and in accordance with detailed instructions; measure self against standard of excellence, overcome obstacles and challenges with little supervision. Benefits - Comprehensive and competitive benefit and pay package including health coverage. - 401k with match and profit share. - PTO and more.

Role Description We are seeking a detail-oriented and analytical Revenue Cycle Coding Denial Specialist (Remote) to join our team. This role plays a key part in identifying denial trends, supporting Accounts Receivable (AR) workflows, and driving resolution through research, coding review, and appeal preparation. The ideal candidate brings strong coding expertise, sharp critical thinking skills, and a solid understanding of the full-billing and reimbursement lifecycle. This position also serves as a coding float, providing flexible support and coverage across coding teams as needed. Key Duties and Responsibilities - Review and analyze denied claims to determine root cause and appropriate resolution - Identify denial trends and collaborate with coding, billing, and AR teams to improve outcomes - Prepare and submit detailed, compliant appeal letters with supporting documentation - Perform coding reviews to ensure accuracy and alignment with payer guidelines, CPT, ICD-10-CM, and HCPCS standards - Partner with AR team members to resolve complex accounts and reduce aging receivables - Communicate with providers and staff to obtain necessary documentation or clarification - Assist with education and feedback to coding and billing staff based on denial findings - Maintain up-to-date knowledge of payer policies, regulatory requirements, and coding updates - Provide coding support across specialties as needed in a float capacity - Participate in process improvement initiatives to enhance revenue cycle performance - Demonstrates appropriate utilization of coding software and coding reference material - Follow up with providers on any documentation that is insufficient, missing, or unclear - Assist providers with questions regarding coding and documentation guidelines - Provide ongoing feedback based on observations from coding documentation and identify opportunities for education and communicate trends to leaders - Keep up to date on carrier policies/guidelines to ensure all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or Payer-specific guidelines Qualifications - Minimum 3 years of coding/medical billing experience - Active certification with credentialing from AHIMA and/or AAPC, must be maintained annually - ICD10 certified and/or extensive work experience - Strong understanding of medical terminology, anatomy, and physiology - Experience with denial management, AR workflows, and appeals - Orthopedic coding experience strongly preferred - Experience with NextGen and SIS systems preferred Knowledge, Skills and Abilities - A strong understanding of physiology, medical terms, and anatomy - Thorough attention to detail - Excellent written and verbal communication skills - Self-motivated team player able to multi-task and prioritize - Excellent organization and interpersonal communication skills - Strong computer skills - Experience with Microsoft Excel, Outlook, and Adobe - Working experience navigating EHR’s to abstract documentation Work Environment/Physical Demands The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions. - Work may be performed in a remote office and clinical environment - Requires corrected vision and hearing to normal range - Regularly required to talk or hear - Required to sit for long periods of time, stand and walk, bend and stretch - Use of telephone and computer is required - Manual dexterity required for use of computer keyboard - Occasionally lifts and carries items weighing up to 40 pounds - May require working under stressful conditions or working irregular hours

Role Description The role of the Revenue Cycle Specialist is a valued member of our Revenue Cycle team. As a Revenue Cycle Specialist, you will work remotely and be responsible for overseeing bill processes including: - Charge entry - Billing - Claims - Patient AR - Insurance AR You will also: - Post payments - Handle credit resolutions - Perform other revenue cycle functions Qualifications - High School diploma or GED - Minimum 1-2 years medical billing experience - CPC or other equivalent certification - Orthopedic Coding Experience a plus - Experience with Nextgen and Amkai Billing Systems preferred Requirements - Verify information for claims is correct prior to billing - Review Surgical coding for accuracy prior to billing - Process all Primary, Secondary, and tertiary claims and address any edits or rejections - Post all patient payments - Post all Insurance and third-party payments - Credit Resolution for both Insurance and Self pay credits - Insurance AR - Patient AR - Process bad debt - Answer phones - Complete duties and assist others as directed - Must follow all policies as introduced during new teammate On-Boarding, updated real-time and outlined in Teammate Handbook Benefits - Comprehensive and competitive benefit and pay package - Health coverage - 401k with match and profit share - PTO and more Work Environment/Physical Demands The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions. - Work may be performed in an office and clinical environment - Requires corrected vision and hearing to normal range - Regularly required to talk or hear - Required to sit for long periods of time, stand and walk, bend and stretch - Use of telephone and computer is required - Manual dexterity required for use of computer keyboard - Occasionally lifts and carries items weighing up to 40 pounds - May require working under stressful conditions or working irregular hours

At Proliance Surgeons our patients come from all walks of life — and so do we. We hire and support people from diverse backgrounds, fostering growth and development to make Proliance a great place to work. Our unique experiences and perspectives help us deliver Exceptional Outcomes, Personally Delivered. We are proud to offer a comprehensive and competitive benefit and pay package including health coverage, 401k with match and profit share, PTO and more! For further details regarding Benefits and Washington State Minimum Wage details please visit our careers page at www.proliancesurgeons.com/careers. Compensation during the offer process will be determined based on factors such as compensation structure, experience, qualifications, and internal equity.  Be Part of Who We Are! Position Summary The role of the Revenue Cycle specialist is a valued member of our Revenue Cycle team. As a Revenue Cycle Specialist, you will work remotely and be responsible for overseeing bill processes including Charge entry, Billing, Claims, Patient AR and Insurance AR. You will also post payments, handle credit resolutions, along with other revenue cycle functions. Key Duties and Responsibilities The key duties and responsibilities of the Revenue Cycle Specialist include, but are not limited to: - Verify information for claims is correct prior to billing - Review Surgical coding for accuracy prior to billing - Process all Primary, Secondary, and tertiary claims and address any edits or rejections. - Post all patient payments - Post all Insurance and third-party payments - Credit Resolution for both Insurance and Self pay credits - Insurance AR - Patient AR - Process bad debt - Answer phones - Complete duties and assist others as directed - Must follow all policies as introduced during new teammate On-Boarding, updated real-time and outlined in Teammate Handbook Education/Experience - High School diploma or GED - Minimum 1-2 years medical billing experience - CPC or other equivalent certification - Orthopedic Coding Experience a plus - Experience with Nextgen and Amkai Billing Systems preferred Knowledge, Skills and Abilities - High level of independence, adaption, and accuracy - Ability to navigate online Payor portals and websites - Ability to effectively use Office equipment - Basic knowledge of Microsoft Office Word and Outlook - Superior customer service skills - Great interpersonal skills; demonstrating patience, composure, and cooperation; working well with all patients, physicians, and staff - Understanding of and adherence to all safety, risk management and precautionary procedures, including the consistent respect for confidentiality (HIPAA) - Using time efficiently, with meticulous attention to detail, accuracy, and completion - Ability to manage multiple factors for the best result - Resourcefulness in addressing first level problems and tenacity to see things through to solution - Ability to remove oneself personally from given situations, remaining objective - Able to adapt to change, delays or unexpected events while maintaining a positive mindset - Clear oral and written communication - Ability to provide feedback to improve performance - Self-motivated; able to work following specific guidelines and in accordance with detailed instructions; measure self against standard of excellence, overcome obstacles and challenges with little supervision Work Environment/Physical Demands The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions. Work may be performed in an office and clinical environment. Requires corrected vision and hearing to normal range. While performing the duties of this job, the associate is regularly required to talk or hear. The associate is required to sit for long periods of time, stand and walk, bend and stretch. Use of telephone and computer is required. Manual dexterity required for use of computer keyboard. Occasionally lifts and carries items weighing up to 40 pounds. May requires working under stressful conditions or working irregular hours. Comments This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.