Accounts Receivable Specialist

Lakeshore Bone and Joint Institute is seeking a skilled Accounts Receivable Analyst to join our Spine Billing Department. As a dedicated expert in exceptional musculoskeletal care, our doctors and staff have served the orthopedic needs of Northwest Indiana since 1968. With state-of-the-art facilities, we are committed to delivering exceptional, compassionate care to our patients.

The Spine Billing Analyst will be an integral part of our spine billing team, responsible for high-dollar medical billing and debt collection. This position will report directly to the spine billing director.

Key Responsibilities:

• Understand insurance benefits and reimbursement policies.
• Critically think and defuse challenging situations in a professional manner.
• Have an in-depth understanding of CPT/ICD-10 coding guidelines, billing procedures, explanation of benefits, insurance rules, and regulations.
• 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 asked.
• Maintain both electronic and hard copies of every spine surgery.
• 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.
• Follow existing billing/collection protocols to ensure correct and prompt reimbursement.
• Research denied/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 of billing concerns, insurance processes, and denial trends. Present questions to the team with a solution-based approach.
• 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.
• Other duties as assigned.

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 and Features:

• Competitive hourly wage to commensurate with experience.
• Excellent benefits package including medical, dental, vision, and life insurance.
• Retirement options including 401(k).
• Wellness benefits including gym membership reimbursement.
• Company-paid holidays.

Physical Requirements:

While performing the duties of this job, 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.

EEO Statement:

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.