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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 patients need to keep moving and keep enjoying their life.

The Spine Billing Supervisor is responsible for providing leadership to the Spine Insurance Specialist team to ensure optimal management filing insurance claims, denial management and adjudication according to LBJI contracts.

Essential Job Functions:

+ Review accounts receivable reports daily

+ Research unpaid and denied insurance claims in an expeditious manner to ensure account resolution and claim payment

+ Verify accuracy and completeness of documentation included with paper claims prior to submission

+ Initiate appeals and/or refile claims for all denials

+ Request refunds according to LBJI policies and guidelines

+ Act as internal resource for staff questions

+ Have an in-depth understanding of insurance rules and regulations, CPT/ICD10 coding information, explanation of benefits and company billing procedure(s)

+ Develop and establish network connections with insurance provider representative(s) as well as other critical department(s) within insurance carrier(s)

+ Communicate with team member(s) and the Director regarding billing issue(s), insurance process(es) and denial trends. Present problems to team with a solution-based approach

+ Coordinate with insurance carriers to obtain electronic payments and remittances for payments to LBJI

+ Review insurance carrier newsletters, mailing and announcements, share updates with the billing department and Director of Revenue Cycle

+ Maintain confidentiality and compliance with HIPAA rules and regulations

+ Process and review claims in all clearinghouses utilized by the billing systems

+ Attend meetings as required

+ Other duties as assigned

Competencies:

+ Knowledge of CPT and ICD-10 codes

+ Knowledge of an Explanation of Benefits

+ Teamwork and conflict resolution

+ Adaptive and flexible

+ Professionalism and work ethics

Required Skills:

+ Ability to analyze situations and solve problems

+ Employ critical thinking and problem solving

+ Ethical reasoning and decision making

+ Strong attention to detail

+ Receptive and responsive feedback

+ Excellent verbal and written communication skills

+ Time management, prioritization, and sense of urgency

+ Maintain patient confidentiality

Experience/Position Requirements:

+ Must be at least 18 years of age

+ Must have reliable transportation

+ Proficiency in Microsoft Word, Excel, and Outlook

+ Digital literacy

Preferred Experience:

Minimum of 2-year medical insurance experience

Minimum Education:

• High School Diploma or the equivalent

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 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 provided to enable people with disabilities to perform the essential functions described of the job.

Environmental/Working Conditions:

Work is performed in an office environment. Involves frequent personal and telephone contact with patients and with testing sites and surgery departments. Work may be stressful at times. Interaction with others is constant and interruptive. Contact involves dealing with injured sick people.

Compliance:

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

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.