- Meet deadlines and productivity standards for Epic work queues, including but not limited to: Insurance verification (Epic RTE), Denials (research root cause, identify trends, correct, appeal), Claim Edits (ensure clean claim submission) & Transaction history (track claim submission and payor response)
- Work the priority Epic work queues , projects and/or accounts and provide immediate feedback to management.
- Utilize payor websites to research policies and coverage eligibility for use in claim adjudication, trend identification, and application for process improvement.
- Utilize MS Office, with an emphasis on Excel to document, trend, and communicate workflow assignments, trends, and information vital to performance.
- Apply transfers and/or adjustments to invoices as necessary to complete the resolution of each invoice.
- Knowledge of ICD-10, Modifiers,Revenue Codes, HCPCS and CPT codes.
- Coordinate data to complete special billing projects based on contractual obligations and regulatory demands.
- Apply knowledge of insurance rules and regulations to interpret new insurance/HCFA/UB/HIPAA information and report potential impact.
- Work along EBNHC Patient Accounts Leadership with various payors as part of the contact group responsible for updates and information required to assist others in the organization.
- Participation in various projects and testing of updates for evaluation and implementation.
- 3+ years of experience in a medical billing
- 3+ years of Epic PB Resolute experience required
- Demonstrate proficiency with a variety of automations, including but not limited to Epic, Microsoft Word, Excel, Email and electronic data processing skills
- Working knowledge of insurance rules and regulations
- Proficiency in PC software (i.e database)
- Ability to manage multiple tasks/projects simultaneously
- Proficiency level understanding of Medical Billing, ICD and CPT coding preferred.
- Strong organizational skills and effective interpersonal skills
- Excellent communication skills (verbal and written)
- Medical, Dental, and Vision Coverage
- Life and Disability Insurance
- 401(K) Retirement Plan
- Tuition Reimbursement
- Flexible Spending and Transportation Accounts
- Paid Holidays, Vacations, Sick, and Personal Time
- Generous Staff Development Benefit
- Excellent Malpractice Coverage
- Pet Insurance
- Free Parking and much more
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Revenue Cycle Specialist III - Boston, United States - East Boston Neighborhood Health Center
Description
Revenue Cycle Specialist IIIEast Boston, MA
Full-time, benefit eligible
Reporting directly to department manager and under the general direction of the Lead Biller, the EBNHC Revenue Cycle Specialist performs a wide spectrum of billing functions to minimize accounts receivable and enhance collection performance. This position is relied upon to train staff and work on any activity within the team with little supervision. Utilize electronic medical billing systems as well as in depth advanced knowledge of medical billing and insurance rules and regulations to resolve accounts receivables issues. This position serves as the primary resource on complex issues and specified duties.
Essential Duties & Responsibilities:
EDUCATION: High School Diploma or equivalent.EXPERIENCE:
SKILLS/ABILITIES:
Benefits:
EBNHC opens our doors to people from all demographics and cultures. Our workforce is as diverse as the city we call home — in gender, race, ethnicity, sexual orientation, disability, religion, and age, as well as in cultural backgrounds, life experiences, thoughts, and ideas.
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