Billing Representative II, Remote

Site: Mass General Brigham Incorporated

Job Summary

Reporting directly to the Team Supervisor and under the general direction of the Billing & Accounts Receivable Manager, the Billing Representative II performs a variety of billing functions to minimize accounts receivable and enhance collection performance. This position is relied upon to work on any activity within the team with little or no direct supervision. Utilizes electronic billing and medical retrieval systems and in-depth knowledge of medical billing and insurance rules and regulations to resolve accounts receivable issues.

Responsibilities

• Achieve excellence in performance by working collaboratively with others on various teams.
• Supports and demonstrates the values of Massachusetts General Brigham by conducting activities ethically with integrity, honesty, and confidentiality. Demonstrates a positive, open-minded, can-do attitude. Represents a team perspective and willingness and enthusiasm to collaborate with others. Follows through on commitments and achieves desired results. Exhibits sound judgment, obtains the facts, examines options, gains support, and achieves positive outcomes.
• Always maintain high professional conduct standards. Represents the CBPO Professional Billing Office at events and projects external to the organization.
• Enthusiastically promote a cooperative team environment to provide value to all customers. Act as a leader in creating a positive atmosphere within the team. Listen and interact tactfully, diplomatically, and effectively without alienating others.
• Perform all aspects of the Billing Representative I position at a consistently high degree of proficiency. This entails a complete understanding of all department policies and procedures to execute all billing tasks with minimal direct supervision. This representative is expected to be a leader within the team in productivity, teamwork, efficiency, communication, and patient care. Act with minimal supervision, notice or direction to identify and resolve problems and complete work.
• Work the most sensitive Epic Workqueues, projects and/or accounts and provide immediate feedback to Team Supervisor on changes or modifications that need to be communicated to appropriate Liaison/department.
• Apply knowledge of insurance rules and regulations to interpret new insurance/HCFA/HIPAA information and report potential impact. Utilize experience and expertise to determine the correct course of action efficiently and effectively on each account/project.
• Effectively handle telephone inquiries from insurance companies and other departments within the PBO. Gather and interpret all relevant information to help resolve issues or complaints. Document issues thoroughly.
• Apply transfers and/or adjustments to invoices as needed to complete each invoice's resolution.
• Request necessary data as appropriate to resolve issue and trends once identified within their work files and follow through on resolutions to completion.
• Coordinate data to complete special billing projects based on contractual obligations and regulatory demands.
• Meet deadlines and productivity standards for Epic Workqueues, including but not limited to:
  • Insurance verification
  • Referral Management
  • Correspondence & phone inquiries
  • Billing/mailing claims/appeals
  • Working claim edits & scrubbers
  • Third party follow-up including secondary billing & rejections
  • Special projects
• Demonstrate proficiency with a variety of automations, including but not limited to EPIC and PCIS, PATCOM, Microsoft Word, Excel, E-mail, Voicemail and Payor Websites.
• Participate in continuous quality improvement efforts. Establish goals with Team Supervisor and track progress. Comply with hospital confidentiality policy. Manage special projects as assigned.
• Perform other duties as assigned.

Qualifications

• Detailed working knowledge of medical terminology, ICD 10 coding and CPT, HCPCS preferred.
• Strong attention to detail.
• Excellent interpersonal, written and verbal communication skills.
• Proficient in Microsoft Office Excel and other relevant billing software.
• Ability to prioritize and manage multiple tasks simultaneously.
• Ability to work independently and as part of a team.
• Ability to work in a fast-paced environment.

Position is for Point32/Commercial Payer Team within Patient Financial Services.

Remote Type: Remote

Work Location: 399 Revolution Drive

Scheduled Weekly Hours: 40

Employee Type: Regular

Work Shift: Day (United States of America)

Pay Range: $19.81 - $28.30/Hourly

Grade: 3

EEO Statement

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.