- 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.
- Maintains good interpersonal relationships with stakeholders internal and external to the department.
- Provides feedback to assist EBNHC management in developing strategies to improve financial service operations.
- 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
- HS Diploma or equivalent: BA preferred
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Revenue Cycle Specialist III - Boston, United States - East Boston Neighborhood Health Center
Description
Revenue Cycle Specialist IIIRemote, Part-time
Are you an experienced Revenue Cycle Specialist seeking to work part time remotely? 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 leverage payer and industry knowledge, collaborate within the Patient Accounts team, and work on any revenue cycle activity 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.
Epic PB Resolute and medical billing experience is required for this position. Strong verbal and written communication skills are needed to be successful in this role. This position is a 100% remote work opportunity. Proof of residency is required in one of the following States (Massachusetts, Maine, Tennessee, Wisconsin, Colorado, Georgia, Pennsylvania, Rhode Island, New Hampshire, Ohio, Michigan, or Florida).
Duties and Responsibilities:
Experience/Education:
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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