Accounts Receivable Analyst - Spine Billing at Lakeshore Bone & Joint Institute

As the region's dedicated experts in exceptional musculoskeletal care, our doctors and staff at Lakeshore Bone & Joint Institute have served the orthopedic needs of Northwest Indiana since 1968. With state-of-the-art facilities, we are dedicated to delivering the exceptional, compassionate care that our patients need to keep moving and keep enjoying their life.

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

• Understand the difference between in and out of network insurance benefits / reimbursement policies.
• Ability to 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 patient with cost estimates when asked.
• Maintain both electronic and hard copy 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 appeal 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 process and denial trends. Present questions to the team with a solution-based approach.
• Verify patients' insurance eligibility, evaluate out of network benefits, and communicate to the patients.
• Understand Lakeshore Bone & Joint Institute company's refund policies.
• Attend meetings as needed.
• Other duties as assigned.

• Must have the capacity to provide exceptional patient centered service when communicating with patients.
• Maintain confidentiality adhering to HIPPA rules and regulations.
• Knowledge of State & Federal laws.
• Comprehension of CPT and ICD-10 codes
• Ability to assess an Explanation of Benefits.
• Understanding of Coordination of Benefits.
• Professionalism and work ethic.

• 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 401k.
• Wellness benefits including gym membership reimbursement.
• Company paid holidays.

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 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.

Skills & Requirements Qualifications