Epic Billing & Denials Specialist

Beth Israel Lahey Health; Boston (MA); On-site; USD 33,000 - 45,000; Full time

Job summary

Beth Israel Lahey Health is seeking a Revenue Cycle Operations Specialist to perform a broad range of medical billing functions across enterprise scope, with emphasis on registration, coverage, and eligibility issues.

The role includes resolving denials, posting adjustments, and rebilling as needed, while collaborating with departments to reduce denials and optimize revenue. Experience with CMS forms and Epic workflows is preferred.

Qualifications

• Strong knowledge of third-party payor reimbursement, eligibility verification process, and government and payor compliance rules.
• Experience with CMS1500 and UB-04 claim forms is preferred.
• Experience in registration billing and denial management environment or front-end access-related field is desirable.

Responsibilities

• Resolve registration, coverage, and eligibility issues in Epic work queues and denials queues.
• Post manual adjustments with appropriate codes and escalate when needed.
• Resolve external clearinghouse edits and payor rejections; rebill when appropriate.
• Collaborate with departments and physicians to identify billing trends and improve workflows.

Skills

Reimbursement knowledge

Eligibility verification

Payor compliance

Education

Associate degree or equivalent experience

Tools

Epic Resolute

Job description

Beth Israel Lahey Health is seeking a Revenue Cycle Operations Specialist to perform a broad range of medical billing functions across enterprise scope, with emphasis on registration, coverage, and eligibility issues.

The role includes resolving denials, posting adjustments, and rebilling as needed, while collaborating with departments to reduce denials and optimize revenue. Experience with CMS forms and Epic workflows is preferred.