Revenue Cycle Specialist III

1 week ago


Boston, Massachusetts, United States East Boston Neighborhood Health Center Full time
Job Title: Revenue Cycle Specialist III

At East Boston Neighborhood Health Center, we are seeking a highly skilled Revenue Cycle Specialist III to join our team. As a key member of our Patient Accounts department, you will play a vital role in ensuring the smooth operation of our revenue cycle processes.

Job Summary:

The Revenue Cycle Specialist III will be responsible for performing a wide range of billing functions to minimize accounts receivable and enhance collection performance. This includes utilizing electronic medical billing systems, as well as in-depth knowledge of medical billing and insurance rules and regulations to resolve accounts receivable issues.

Key Responsibilities:
  • Meet deadlines and productivity standards for Epic work queues, including insurance verification, denials, claim edits, and transaction history.
  • Work on 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 process improvement.
  • 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 with NeighborHealth 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.
Requirements:
  • High School Diploma or equivalent.
  • 3+ years of experience in a medical billing environment.
  • 3+ years of Epic PB Resolute experience required.
  • Demonstrate proficiency with a variety of automations, including Epic, Microsoft Word, Excel, Email, and electronic data processing skills.
  • Working knowledge of insurance rules and regulations.
  • Proficiency in PC software (i.e., database).
  • Ability to manage multiple tasks/projects simultaneously.
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.


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