Accounts Receivable Specialist
3 weeks ago
We are seeking a highly skilled and detail-oriented Accounts Receivable Analyst to join our team at Lakeshore Bone and Joint Institute. As a key member of our Spine Billing Department, you will be responsible for managing high-dollar medical billing and debt collection.
Key Responsibilities:- Understand and navigate complex insurance benefits and reimbursement policies.
- Critically think and resolve challenging situations in a professional manner.
- Have a deep understanding of CPT/ICD-10 coding guidelines, billing procedures, and 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 queues to prioritize high-dollar claims.
- Provide patients with cost estimates when requested.
- 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 regarding billing concerns, insurance processes, and denial trends.
- Verify patients' insurance eligibility, evaluate out-of-network benefits, and communicate with patients.
- Understand Lakeshore Bone and Joint Institute's refund policies.
- Attend meetings as needed.
- Other duties as assigned.
- 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.
- 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.
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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