Billing Representative II

Massachusetts General Hospital; Somerville (MA); Remote; USD 45,000 - 65,000; Full time

Job summary

Massachusetts General Hospital invites qualified applicants for the Billing Representative II role, directly supporting credit resolution activities. You will engage in electronic billing, apply extensive medical billing knowledge, and manage inquiries to enhance collection performance. This position promises a chance to thrive in a supportive, high-performing team environment dedicated to exceptional patient care.

Qualifications

• Three years experience in high volume medical billing.
• Detailed knowledge of medical terminology, ICD 10 coding, and HCPCS.
• Ability to manage multiple tasks/projects simultaneously.

Responsibilities

• Performs various billing functions to minimize credit accounts receivable.
• Applies expert knowledge of insurance rules to interpret new information.
• Handles inquiries regarding credits from customers and resolves issues.

Skills

Effective communication

Organizational skills

Problem-solving skills

Analytical skills

Customer service skills

Education

High School Diploma or GED equivalent

Tools

Epic System knowledge

Microsoft Word

Microsoft Excel

Job description

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Reporting directly to the Manager and under the general direction of the Senior Manager of Credit Resolution, the Billing Representative II performs various billing functions to minimize credit accounts receivable and enhance collection performance. The position utilizes electronic billing and medical retrieval systems and in-depth knowledge of medical billing and insurance rules and regulations to resolve accounts receivable and credit issues.

Essential Functions
- Achieve excellence in performance by working collaboratively with others on MGB RCO and Enterprise Initiatives
- 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.
- Drives DE&I (Diversity, Equity, & Inclusion) and recognizes the value that different perspectives and cultures bring to an organization.
- Create and foster an atmosphere of continuous improvement.
- Always maintain high professional conduct standards. Represents the MGB RCO 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.
- Develop relationships with all levels to modify/create procedures to reduce backlogs and improve financial performance.

Account Management
- 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. Act with minimal supervision, notice or direction to identify and resolve problems and complete work.
- Ability to work on the most sensitive and/or high-profile patient accounts, projects and/or accounts as directed. Provide immediate feedback to Manager on changes or modifications that need to be communicated to appropriate departments within the MGB RCO.
- Apply expert 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 all customers including patients, insurance companies and other departments within the PBO. Gather and interpret all relevant information to help resolve issues or complaints. Document issues thoroughly.
- Coordinate data to complete special billing projects based on contractual obligations and regulatory demands.
- Apply transfers and/or adjustments to invoices as necessary to complete the resolution of each invoice.
- Provide detailed summaries of issues/requests with supportive data to management. Recommend resolutions, workflows, and identify root cause. Must be able to exercise proper judgment as necessary and raise issues to the appropriate management level.
- Meet deadlines and exceed both productivity and quality standards for Epic Workqueues, including but not limited to:
1. Insurance verification
2. Retraction Requests
3. Correspondence & phone inquiries
4. Special projects
5. Other job duties as assigned

- Demonstrate proficiency with a variety of automations, including but not limited to Epic, Microsoft Word, Excel, E-mail, Voicemail and Payor Websites.

- Effectively handle all inquiries regarding credits from customers including, insurance companies and other departments within the PBO. Gather and interpret all relevant information to help resolve issues or complaints. Document issues thoroughly. Utilize collections experience and expertise to determine the correct course of action efficiently and effectively on each account/project.
- Perform other duties as assigned

Qualifications

• High School Diploma or GED equivalent required
• Three years experience in high volume medical billing and Billing/Accounts Receivable systems required.
• Epic System knowledge preferred
• Effective communication, organizational and problem-solving skills
• Detailed working knowledge of medical terminology, ICD 10 coding and CPT, HCPCS required.
• Knowledge of medical Billing, insurance rules and regulations required
• Solid written skills essential

• Excellence in customer service skills
• Effective communication and interpersonal skills to successfully interact with internal and external customers
• Effective organizational and problem-solving skills
• Strong analytical skills
• Ability to manage multiple tasks/projects simultaneously
• Must be able to act with minimal supervision, notice or direction to complete work and identify/resolve problems by utilizing billing knowledge and experience. Must be independent.
• Demonstrated proficiency with a variety of automations, including but not limited to Epic, Microsoft Word, Excel, Email, and electronic data processing skills
• Must be able to show expert knowledge of key processes while demonstrating a complete understanding of where each job within Patient Financial Services fits into the organization's overall mission.
• Established as a dynamic and positive team player, able to work independently and in a group/team setting
• Detail oriented
• Must be able to develop training curriculum and conduct training sessions as needed
• Adapt positively to changes in the work setting with ease

Additional Job Details (if applicable)

• M-F Eastern Business hours
• Quiet, secure, stable, compliant work station required for remote role

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

EEO Statement:

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.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.