Patient Accounting Billing Specialist

Overview

The primary function of the Patient Accounting Billing Specialistis the daily management of an assigned portion of the accounts receivable, typically allocated based on alphabetical splits.

Responsibilities of the Patient Accounting Billing Specialist include regular and consistent billing for all payers and follow-up work on Client, inter-hospital billing, NMDP, Bluebird Bio, and Gift of Life accounts to ensure accurate reimbursement and final adjudication of claims as needed. Works prebilling edits in the billing and scrubber systems to ensure timely submission of claims in accordance with department expectations. May also perform other duties as assigned, including but not limited to, special patient accounting projects, charge entry, and cash applications. The Patient Accounting Billing Specialist II performs analysis of persistent billing issues and recommends resolution to management and Identifies trends in the billing and scrubber systems.

The Patient Accounting Billing Specialist will have regular exposure to patient demographics, diagnostic, and billing information. Additionally, will be exposed to physician information including physician numbers assigned by governmental agencies and insurance carriers.

T he selected candidate must live and work from one of the New England states (ME, NH, VT, MA, RI, CT)

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Responsibilities

With moderate supervision, the Patient Accounting Billing Specialist:

• Reviews payments and resolve unpaid balances.
• Performs effective and timely collection activity on unpaid client accounts.
• Reviews and resolves credit on client accounts.
• Updates crossover insurance that is missing in the billing system to resolve undistributed payments.
• Triage accounts to the responsible parties in the billing system to ensure claims are addressed promptly.
• Updates issues grid with examples of impacted accounts.
• Operates on multiple systems as assigned. Will use Epic, FISS, Connex, Nehen, and FinThrive for processing and follow-up activity for Inpatient/Outpatient claims as assigned.
• Keeps informed on updates to billing requirements, editing, and payer policies affecting billing.
• Informs supervisor of changes to billing regulations.
• Meets department productivity and qualitative standards.
• Works account and claim edits in the hospital billing system.
• Works rejections, edits and accounts in the incomplete folder in the claim scrubber system (FinThrive), consistent with the department standards.
• Performs analysis of persistent billing issues and recommends resolution to management.
• Assists the supervisor with coaching and training new or existing billing specialists as needed.
• Identifies trends in the billing and scrubber systems.
• Assist with troubleshooting and resolving issues in the absence of the P/A Billing Specialist.
• Assists the Supervisor in recording minutes for the staff meetings.
• Meets department productivity and qualitative standards.
• Handles complex billing issues.
• Reassigns staff assignments in their absence.
• Assists in maintaining billing information on the shared drive for staff easy access.
• Collaborates with JV partners to resolve coding and ADT issue.
• Performs other duties as assigned.

SUPERVISORY RESPONSIBILITIES:

None; coaches and trains new staff, available as a strong resource.

Qualifications

• Minimum Education:
  • High school diploma required; bachelor’s degree preferred.
• Minimum Experience :
  • 3-5 years of previous billing experience required.
  • Experience working with various software applications, including Microsoft Office and various billing software preferred.
  • Experience with patient account applications and procedures preferred.
• License/Certification/Registration:
  • N/A

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

• Strong knowledge of third-party billing regulations, as well as of hospital and/or professional operations, and third-party payer requirements.
• Ability to remain in full compliance with all departmental, institutional, and regulatory policies and procedures.
• High degree of confidentiality.
• Working knowledge of industry-standard medical coding conventions.
• Dependable, self-starter, and deadline driven.
• Strong oral and written communication skills.
• Ability to work well independently.

At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong. As relentless as we are in our mission to reduce the burden of cancer for all, we are equally committed to diversifying our faculty and staff. Cancer knows no boundaries and when it comes to hiring the most dedicated and diverse professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.

Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.