Revenue Cycle Specialist III
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What you'll do
- 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 payor websites to research policies and coverage eligibility for use in claim adjudication, trend identification, and application for process improvement.
- Utilize MS Office, with an emphasis on Excel to document, trend, and communicate workflow assignments, trends, and information vital to performance.
- 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 along 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.
- Maintains good interpersonal relationships with stakeholders internal and external to the department.
- Provides feedback to assist NeighborHealth management in developing strategies to improve financial service operations.
What they're looking for
- High School Diploma or equivalent
- 3+ years of experience in a medical billing
- 3+ years of Epic PB Resolute experience required
- Demonstrate proficiency with a variety of automations, including but not limited to 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
Nice to have
- Proficiency level understanding of Medical Billing, ICD and CPT coding preferred
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
Thank you for your interest in a career at NeighborHealth, formerly East Boston Neighborhood Health Center!
As one of the largest community health centers in the country, NeighborHealth is proud to serve the greater Boston area with a strong commitment to the health and well-being of our patients and communities.
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential support staff who keep our operations running smoothly — every role at NeighborHealth is vital. Together, we’re advancing medicine and delivering the best care experience for our patients and community!
Interested in this position? Apply online and create a personal candidate account!
Current Employees of NeighborHealth- Please use our internal careers portal to apply for positions.
To learn more about working at NeighborHealth and our benefits, please visit out our Careers Page.
Time Type:
Full timeDepartment:
Patient AccountsAll Locations:
300 Ocean Avenue – ReverePosition Summary:
Revenue Cycle Specialist performs a wide spectrum of billing functions to minimize accounts receivable and enhance collection performance. 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.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 payor websites to research policies and coverage eligibility for use in claim adjudication, trend identification, and application for process improvement.
Utilize MS Office, with an emphasis on Excel to document, trend, and communicate workflow assignments, trends, and information vital to performance.
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 along 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.
Maintains good interpersonal relationships with stakeholders internal and external to the department.
Provides feedback to assist NeighborHealth management in developing strategies to improve financial service operations.
EDUCATION: High School Diploma or equivalent.
EXPERIENCE:
3+ years of experience in a medical billing
3+ years of Epic PB Resolute experience required
Demonstrate proficiency with a variety of automations, including but not limited to 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
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
Pay Range
Starting at $24.00 up to $36.00 depending on experience
EEO & Accommodation Statement:
NeighborHealth is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to HRrecruit@NeighborHealth.com or call 617-568-4480 to let us know the nature of your request
Federal Trade Commission Statement:
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website. We do not ask or require downloads of any applications, or “apps.” Job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.
E-Verify Program Participation Statement:
NeighborHealth participates in the Electronic Employment Verification Program, E-Verify. As an E-Verify employer, all prospective employees must complete a background check before beginning employment.
Company
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