Billing Representative II

Davita Inc.; Somerville (MA); On-site; USD 50,000 - 75,000; Full time

Job summary

Une entreprise de soins de santé bien établie cherche un Billing Representative II pour optimiser la facturation médicale. Le candidat idéal aura de l'expérience avec des systèmes de facturation, démontrant précision et compétences en résolution de problèmes. Ce poste nécessite des compétences interpersonnelles fortes et une capacité à travailler de manière autonome. Le membre de l'équipe contribuera à l'amélioration continue de l'organisation tout en respectant l'éthique et l'intégrité.

Qualifications

• Trois ans d'expérience en facturation médicale et systèmes de facturation/requêtes.
• Connaissance approfondie de la terminologie médicale et des règles de facturation.
• Capacité à travailler sous supervision minimale.

Responsibilities

• Résoudre les crédits et facturations pour les comptes clients.
• Gérer les demandes spéciales de facturation selon les obligations contractuelles.
• Assurer un service client exemplaire tout en maintenant des normes professionnelles élevées.

Skills

Communication

Organization

Problem Solving

Analytical

Customer Service

Education

High School Diploma or GED

Tools

Epic System

Microsoft Word

Microsoft Excel

E-mail

Job description

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

• 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

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

Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. 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.