- Reviews all claims in Accounts Receivable in their work-log. Takes necessary action to resolve encounters in a timely manner, ensuring accurate payment for services provided.
- Maintains a thorough knowledge of third party requirements for claim adjudication.
- Advises manager of any payer changes or trends in claims processing, denials or payments.
- Exercises good judgment in working accounts.
- Utilizes all resources available, including electronic inquiries to verify eligibility, benefits, status of claims and for claim reconsiderations.
- Demonstrates excellent customer service skills when responding to incoming calls in a most courteous manner providing clear and appropriate information as needed.
- Works correspondence daily.
- Updates demographic and financial information in practice management system as needed.
- Documents all activity on account in a clear, accurate and consistent manner.
- Works credit balance report timely, submitting requests for refunds or adjusting account as appropriate.
- Demonstrates the ability to reconcile payments and contractuals when reviewing accounts in order to ensure the accuracy of the account balance.
- Attends BIDPO insurance seminars/orientation.
- Attends and actively participates in staff meetings.
- Adheres to HIPAA privacy and confidentiality regulations and guidelines.
- Submits required productivity reports, which should reflect accurately the work performed.
- Performs other duties as assigned.
- High School Diploma Required
- Minimum of 2 years' experience in medical billing is essential; experience with hospital billing a plus
- CPT/ICD-10 a plus but not required
- Strong analytical and mathematical skills
- Outstanding customer service
- Very good verbal and written communication skills (English)
- Bilingual a plus
- Must be detail oriented, with the ability to prioritize responsibilities – through completion
- Ability to work independently and with minimal supervision
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Description
Overview
The Revenue Cycle's Insurance Specialist's primary responsibility is to work and resolve unpaid and denied claims. This position also provides customer service, updates account demographic and insurance information, and works credit balance reports.
This is a part-time position (20 hours per week)
5 (4 hour) or 4 (5 hour) days. Monday-Friday
After initial training/orientation on-site, the role has remote option available.
As a health care organization, we have the 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.
