- Efficiently researches and appropriately resolves billing edits.
- Researches denied accounts, partially paid or denied line items. Determines appropriate appeal, contractual adjustments or bills to next payer.
- Reviews payer rejections and makes corrections to ensure payer acceptance of claims.
- Follows up with the payers regarding claims that have not been paid and escalates as needed.
- Independently analyzes and resolves credit balance and documents actions in the billing system.
- High School diploma or GED required. Associate's degree preferred.
- 1-3 years related work experience required.
- Proficient key boarding skills for data entry and ability to navigate between more than one computer system.
- Ability to work independently as well as part of a team; ability to work effectively in a fast paced environment.
- Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
- Two or more years of customer service experience and/or basic knowledge of third party coverage, registration and billing.
- Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.
- Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
- Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.
- Written Communications: Ability to communicate clearly and effectively in written English with internal and external customers.
- Oral Communications: Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.
- Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.
- Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.
- Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.
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Third Party Billing Specialist - Boston, United States - Beth Israel Lahey Health
Description
When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.Job Type:
Regular
Scheduled Hours:
40
Work Shift:
Day (United States of America)
Efficiently and accurately completes the intermediate level Accounts Receivable tasks to resolve both pre- and post-billing and payment issues. Ensures the highest level of collection and the lowest level of denials.
Job Description:
Essential Responsibilities:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally
FLSA Status:
Non-Exempt
As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.
More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.
Equal Opportunity Employer/Veterans/Disabled