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NeighborHealth

Revenue Cycle Specialist III

NeighborHealth, Boston, Massachusetts, us, 02298

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Revenue Cycle Specialist III Location:

151 Orleans Street, Boston, MA

Time Type:

Full time

Department:

Patient Accounts

Position Summary:

Revenue Cycle Specialist performs a wide spectrum of billing functions to minimize accounts receivable and enhance collection performance. Utilizes electronic medical billing systems and advanced knowledge of medical billing and insurance rules and regulations to resolve accounts receivable issues. This position serves as the primary resource on complex billing matters and specified duties.

Essential Duties & Responsibilities

Meet deadlines and productivity standards for Epic work queues, including insurance verification (Epic RTE), denial research, claim edits, and transaction history tracking.

Work priority Epic work queues, projects, and accounts, providing immediate feedback to management.

Use payor websites to research policies and coverage eligibility for claim adjudication, trend identification, and process improvement.

Utilize MS Office, emphasizing Excel, to document, trend, and communicate workflow assignments and performance metrics.

Apply transfers and adjustments to invoices as necessary to resolve each invoice.

Maintain 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.

Interpret new insurance, HCFA, UB, and HIPAA information and report potential impact.

Collaborate with Patient Accounts leadership and payors as part of the contact group responsible for updates and information sharing.

Participate in projects and testing of updates for evaluation and implementation.

Education High School Diploma or equivalent.

Experience

3+ years of experience in medical billing.

3+ years of Epic PB Resolute experience.

Proficiency with Epic, Microsoft Office (Word, Excel, Email), and electronic data processing.

Knowledge of insurance rules and regulations.

Proficiency in PC database software.

Ability to manage multiple tasks/projects simultaneously.

Skills / Abilities

Strong understanding of medical billing, ICD and CPT coding.

Excellent organizational and interpersonal skills.

Strong verbal and written communication skills.

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

Staff development benefits

Excellent malpractice coverage

Pet insurance

Free parking

Salary Salary range: $63,000 – $73,000 per year.

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