Billing Representative II, Multi-Specialty Provider Services- Northampton, Hybrid

3 weeks ago


Northampton, United States Partners Healthcare System Full time

About Us

With energy and purpose, Cooley Dickinson Health Care, an affiliate of Mass General Brigham, is advancing health care in western Massachusetts. With a broad network of providers and facilities serving the Pioneer Valley, our services span a spectrum of medical and surgical needs, diagnostic care, rehabilitation, social work, behavioral health, and other critical needs of the community.

The Cooley Dickinson culture is built on living the values of our organization. Every employee is valued, no matter what professional function. Come work where you can make a difference every day, with opportunities for growth and development, in a great place to call home

Department Information & Location

Located in the McCallum Building at 30 Locust Street, Northampton, MA (3rd floor) with free parking

Schedule

Full-Time, 40 hours a week with flexible shifts between 7am and 4:30pm. The first 90 days are on-site for in office training from 7:30am to 4:00pm. After successful training, ability to work 2-3 days remote per week.

Due to the hybrid nature of the role, we ensure that our employees receive required technology and training to be proficient and independently productive in all job responsibilities regardless of work location. Employees are responsible for designating a workspace within the remote work location that is private, safe, ergonomic, and free from distractions for all hours worked.

General Summary

The Billing Representative II is responsible for performing a variety of duties related to patient account billing for professional provider claims and processing of accounts receivable for Cooley Dickinson Medical Group (CDMG). The Billing Representative II works collaboratively within a team environment and provides back up and supports other department staff when needed.

Primary Duties to Include:

Works sensitive and challenging work queues, projects, and/or accounts and provides immediate feedback to Billing Manager on changes or modifications that need to be communicated to appropriate liaison/department.

Manages outstanding accounts according to established department policies, procedures, and goals with high degree of proficiency and minimal direct supervision.

Tracks and monitors denials for trends. Reports findings to billing manager for the purpose of improving clean claims and reducing denials.

Resubmit corrected claims electronically and on payor portals.

Accurately researches all carrier policies and procedures to update your team and manages accounts appropriately with minimal direct supervision.

Meet deadlines and productivity standards unassisted for the work queue assigned, including but not limited to:

* Insurance verification
* Correspondence
* Billing/mailing claims
* Working claim edits & scrubbers
* Third party follow-up including secondary billing

Qualifications

* High school diploma or equivalent. Knowledge of health insurance contracting principles, reimbursement, terms, and conditions required. Demonstrated proficiency in computerized data entry required. EPIC experience preferred.
* At least three (3) to five (5) years of experience in provider medical billing and patient accounts receivable functions strongly preferred.
* Must have experience problem solving and analyzing claim denials.
* Must possess effective communication skills with insurance companies through appeals or telephone calls to resolve claim issues.



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