Revenue Cycle Specialist

Lakeshore Bone & Joint Institute is seeking a highly skilled Revenue Cycle Analyst to join our team. As a key member of our revenue cycle team, you will play a critical role in ensuring the accuracy and efficiency of our billing and reimbursement processes.

• Conduct thorough analysis of designated KPIs to monitor timeliness of charge posting, charge capture rates, clean claim rates, coding errors, and other key performance indicators.
• Review and validate CPT and ICD-10 coding to ensure appropriateness of billing and reimbursement by payers.
• Identify and implement policy and procedure improvements to maximize reimbursement and minimize delays in claims adjudication.
• Oversee the determination of standard fees and maintain procedures for monitoring reimbursement compliance with payer contracts.
• Monitor insurance company payment policies for changes that impact reimbursement.
• Ensure compliance with Federal and State regulations and company policies that govern Medicare and state payment systems.

• Associate degree or equivalent in healthcare or related field.
• Minimum five years' experience with an orthopedic physician group practice.
• Strong background in medical billing.
• Proficiency with Excel and Word.
• Experience with medical billing software and insurance regulations.

• Knowledge of orthopedic medical terminology and coding.
• Experience with medical billing software and insurance regulations.
• Strong attention to detail and accuracy.
• Ability to analyze and interpret medical records and insurance claims.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Strong problem-solving and analytical skills.
• Ability to handle confidential information with discretion.
• Flexibility and adaptability to changing needs and priorities.

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.

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 and the ability to focus. Reasonable accommodation can be made to enable people with disabilities to perform the described essential functions of the job.

All employees have a responsibility to comply with our organization's policies and procedures, adhere to our Code of Conduct, complete required compliance training modules, and report any observations of non-compliance.

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.