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Revenue Cycle Specialist Iii

4 months ago


Boston, United States NeighborHealth Full time

**Thank you for your interest in a career at NeighborHealth, formerly East Boston Neighborhood Health Center**:
Everywhere you turn, you can feel the immeasurable level of enthusiasm here at NeighborHealth We are one of the largest community health centers in the country, supporting the greater Boston area and focusing on the well-being of our patients and local community. From the nurses and physicians on the front line of patient care, to the managers who lead and guide our staff, to the many support roles that keep our facilities running smoothly - everyone plays a vital role in improving medicine for our patients.

**Current Employees of **NeighborHealth**:
To learn more about working at NeighborHealth and our benefits, please visit out our Careers Page.

**Time Type**:
Full time

**Department**:
Patient Accounts

**All Locations**:
East Boston

**Description**:
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**
- 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 MS Office, with an emphasis on Excel to document, trend, and communicate workflow assignments, trends, and information vital to performance.
- 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.
- 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.

**EDUCATION**: High School Diploma or equivalent.

**EXPERIENCE**:

- 3+ years of experience in a medical billing
- 3+ years of Epic PB Resolute experience required
- Working knowledge of insurance rules and regulations
- Proficiency in PC software (i.e database)
- Ability to manage multiple tasks/projects simultaneously

**SKILLS/ABILITIES**:

- Proficiency level understanding of Medical Billing, ICD and CPT coding preferred.
- Strong organizational skills and effective interpersonal skills
- Excellent communication skills (verbal and written)

**BENEFITS**:

- 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