Revenue Billing Specialist
Company: Beth Israel Lahey Health
Posted on: June 12, 2021
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Welcome to Shared Services, our team uses a coordinated approach
to delivering administrative and operational services across Lahey.
Our Shared Services colleagues leverage resources across the
organization to ensure we provide high-quality, high-value care to
the communities we proudly serve. The Shared Services team includes
colleagues who focus on business and network development, legal
services, facilities and real estate, human resources, information
technology, finance, philanthropy and marketing and
About the Job
The PFS Medical Billing Specialist role specializes in complex
denials/specific issues and is vital to ensure that accounts are
thoroughly reviewed for any opportunity to bill insurance, correct
errors, re-file and or appeal for corrected processing and
reimbursement of physician charges. The role also includes review
and analysis of physician billing related issues and errors as well
as education to reduce errors and denials and increase professional
Essential Duties & Responsibilities including but not limited
- Responsible to work and resolve all back end physician billing
denials as assigned. Reviews and completes continuous daily work
queue volume for related denials.
- Responsible to work and respond to all customer service
inquiries in regards to physician billing related patient accounts
- Responsible to work claim rejections due to physician billing
related issues returned by the payor preventing claims
- Makes necessary updates to the Epic patient registration and
initiates rebilling, correcting billing or denials explanation back
to customer service as assigned.
- Researches systems for active insurance coverages for self pay
balances beyond set thresholds to prevent missed cash collection
- Works with department throughout the organization, third party
vendors and insurance carriers to resolve issues related to
physician billing and customer inquiries.
- Works with Hospital, Professional and Home Health Billing Teams
when identifying trends that can lead to inappropriate billing to
- Working in a SBO (Single Billing Office), environment the
Medical Billing Specialist will need to have knowledge in Hospital
and Professional Billing in order to assist with customer on
questions and accurate registration of insurance and or processing
physician billing denials.
- Proactively identifies problems and opportunity for
improvements related to system usage, training and end user
education, practice and user trends and makes recommendations to
the Manager of Revenue System Operations and partners with the
Manager of Epic Training and/or the perspective departments with
high volume/high dollar value for resolution.
- Assists in the development of reporting mechanisms to identify
trends and track so that education can be performed to reduce
and/or resolve high dollar/high volume values.
- Completes all assignments per the turnaround standards. Reports
unfinished assignments to the Manager or Revenue Support
- Attends meetings and serves on committees as requested.
- Achieves exemplary audit results and consistently exceeds
- Provides and promotes ideas geared toward process improvements
within the Central Billing Office.
- Independently works on the resolution of complex claims issues,
denials and appeals.
- Completes projects and research as assigned.
- Provides support for the mentoring and training of new and end
existing A/R staff as required following the training program set
forth to include but not limited to policy and procedures, Epic
system functionality, audits and staff reviews
- Enhances professional growth and development through in-service
meetings, education programs, conferences, etc.
- Complies with policies and procedures as they relate to the
- Exercises care in the operation and use of equipment and
reference materials. Performs routine cleaning and preventive
maintenance to ensure continued functioning of equipment. Maintains
work area in a clean and organized manner.
- Refers complex or sensitive issues to the attention of the
Manager of Revenue System Operations to ensure corrective measures
are taken in a timely fashion.
- Accepts and learns new tasks as required and demonstrates a
willingness to work where needed.
- Assists other staff as required in the completion of daily
tasks or special projects to support the department's
- Performs similar or related duties as assigned or
- High School Diploma required, bachelor's degree preferred
Licensure, Certification & Registration:
- Billing Certification Preferred
- 5 years of experience in registration billing and denial
management environment related field or front end access related
field. Experience in training and staff development
Skills, Knowledge & Abilities:
- Strong knowledge of third party payor reimbursement,
eligibility verification process and government and payor
Beth Israel Lahey Health is an integrated system providing
patients with better care wherever they are. Care informed by
world-class research and education. We are doctors and nurses,
technicians and social workers, innovators and educators, and so
many others. All with a shared vision for what healthcare can and
should be. We are committed to attracting, developing and retaining
top talent. We strive to create a diverse and inclusive workplace
that reflects the communities in which we work and serve. With a
team approach to care, we encourage learning and growth at all
levels and offer competitive salaries and benefits.
Keywords: Beth Israel Lahey Health, Boston , Revenue Billing Specialist, Other , Burlington, Massachusetts
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