Spire Orthopedic Partners Hiring for Associate – Collections Job at Great Neck, NY Full Time

Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Rooted in the 100-plus-year legacy of its founding partners, the network spans the Northeast with 100physicians, over 1000 employees and 23 locations from Connecticut, New York and Massachusetts.

We are an equal opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-869-1145 (for reasonable accommodation requests only).

Please provide all information requested to assure that you are considered for current or future opportunities.

Major Accountabilities:

• Contacts insurance carriers to inquire about unpaid/pending claims (Aged Outstanding Insurance Claims Report).
• Re-filing claims to insurance vendors electronically or on paper.
• Notes actions taken in patients’ accounts by use of Fast Notes, collection, billing and/or insurance notes.
• Resolves denials, rejected and zero EOBs (explanation of benefits) from insurance carriers.
• Review charts for submission to physicians to for letter of medical necessity for outstanding claims
• Prints out medical notes for claim processing for payments
• Ensures all HIPAA regulations are adhered to.
• Follows Spires’ policies and procedures.
• Review and answer chart flags.
• Navigate through the EMR to find the required patient medical information.
• Communicates effectively with other staff at outside facilities.
• Prioritizes workload and develops system to track prior authorizations needing additional follow-up.
• Takes personal responsibility for work. Fosters teamwork, taking initiative to teach pre-authorization team members, clinic staff, and management about pre-authorization processes and insurance requirements
• Maintains confidentiality of patient records.
• Performs other duties/projects as assigned.

Qualifications:

• Qualified candidates must possess the ability to analyze, retain, and resolve issues and provide superior customer service to client base.
• Able to work independently and productively, be organized.
• Knowledge of basic Excel.
• Ability to be a team player, communicate effectively and meet deadlines.
• Minimum of three years previous billing experience required, health care industry experience preferred.

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