About us
Tillges Orthotic and Prosthetic is a small, fast-paced, family-owned business. Tillges provides upper and lower limb prosthetics, bracing, custom foot inserts and diabetic shoes. We are dedicated to embracing modern technology while maintaining traditional values, to provide orthotic and prosthetic services that enhance the quality of life for every person we serve.
This position requires a professional demeanor, as well as the ability to work well with patients, medical professionals, and other staff members. The successful candidate will be reliable, punctual, and able to handle confidential information with discretion.
Job Summary
The Medical Administrative Billing Professional – Orthotics & Prosthetics (O&P) is responsible for managing billing operations related to orthotic and prosthetic devices and services. This role ensures accurate coding, documentation, and claim submission in compliance with payer guidelines, including Medicare, Medicaid, and private insurers. The biller plays a key role in optimizing reimbursement while supporting clinicians and patients throughout the revenue cycle.
Key Responsibilities
- Prepare, review, submit, and track claims for orthotic and prosthetic devices, fittings, and related services
- Assign appropriate billing codes, including HCPCS Level II (L-codes), CPT, and ICD-10 codes
- Verify patient insurance eligibility and benefits specific to O&P services
- Ensure documentation meets payer requirements, including physician orders, proof of delivery, and medical necessity
- Review and track prior authorizations and pre-certifications
- Monitor claim status and follow up on denials, rejections, and unpaid claims
- Appeal denied claims with supporting clinical documentation
- Post payments (must have experience), adjustments, and reconcile accounts receivable
- Communicate with patients regarding coverage, out-of-pocket costs, and payment plans
- Maintain compliance with Medicare DMEPOS regulations
- Collaborate with prosthetists, orthotists, and administrative staff to ensure accurate billing workflows
- Generate reports on billing performance, aging accounts, and reimbursement trends
Qualifications
- High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred
- Certification in medical billing/coding (e.g., CPC, CBCS) preferred
- 5+ years of experience in medical billing, preferably in DME, orthotics, prosthetics, or rehabilitation services
- Knowledge of HCPCS Level II coding (especially L-codes) strongly preferred
- Familiarity with Medicare, Medicaid, and commercial payer guidelines for O&P services
- Experience with EHR/EMR systems, billing software, and payer websites/portals.
- At minimum, 2 years of leadership experience within a Billing department.
Skills and Competencies
- Strong attention to detail, especially with complex coding and documentation requirements
- Knowledge of insurance verification and prior authorization processes
- Excellent problem-solving skills for claim denials and reimbursement issues
- Strong communication and customer service skills
- Ability to manage multiple claims and deadlines efficiently
- High level of integrity and ability to maintain HIPAA compliance
Pay: $26.00 - $30.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
