Accounts Receivable Specialist

7 days ago

Chesterton, Indiana, United States LAKESHORE BONE & JOINT INSTITUTE Full time
Job Title: Accounts Receivable Analyst

Lakeshore Bone & Joint Institute is seeking a highly skilled Accounts Receivable Analyst to join our team in the Spine Billing Department.

Job Summary:

We are looking for a detail-oriented and organized individual to manage high-dollar medical billing and debt collection. The successful candidate will have a strong understanding of CPT/ICD-10 coding guidelines, billing procedures, and insurance rules and regulations.

Key Responsibilities:
  • Understand and apply in-depth knowledge of insurance benefits and reimbursement policies.
  • Critically think and defuse challenging situations in a professional manner.
  • Negotiate single-case agreements with Third Party Administrators for out of network providers.
  • Review insurance payments and confirm accuracy of reimbursement based on contracts, fee schedules, or approved negotiated agreements.
  • Manage daily work queue to prioritize high-dollar claims.
  • Provide patients with cost estimates when requested.
  • Maintain electronic and hard copy records of spine surgeries.
  • Document all communications in a practice management system and include follow-up dates.
  • Verify accuracy and completeness of documentation included with paper claims prior to submission.
  • Research denied or underpaid claims and send appeals promptly to ensure proper resolution and payment.
  • Organize and gather medical billing records upon request from insurance companies, attorney offices, and audit contractors.
  • Communicate with team members and the spine billing director on billing concerns, insurance processes, and denial trends.
  • Verify patients' insurance eligibility, evaluate out-of-network benefits, and communicate with patients.
  • Understand Lakeshore Bone & Joint Institute's refund policies.
  • Attend meetings as needed.
Requirements:
  • Must be at least 18 years of age.
  • High school diploma or equivalent required; associate or bachelor's degree preferred.
  • Health insurance experience preferred.
  • Must have reliable transportation.
  • Digital literacy.
  • Medical terminology.
Benefits:
  • Competitive hourly wage commensurate with experience.
  • Excellent benefits package including medical, dental, vision, and life insurance.
  • Retirement options including 401k.
  • Wellness benefits including gym membership reimbursement.
  • Company-paid holidays.
Physical Requirements:

The employee may be required to sit and/or stand for prolonged periods, work longer than eight (8) hour shifts, and to work both day/evening shifts. Work may require hand dexterity as well as the need to reach, climb, balance, stoop, kneel, crouch, talk, and hear. The employee must occasionally lift and/or move up to 50 lbs. While performing the responsibilities of the job, the employee is required to talk and hear. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to focus. Reasonable accommodation can be made to enable people with disabilities to perform the described essential functions of the job.

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status.

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