Hybrid Billing Specialist - Patient Accounts & Denials

South Shore Health; Weymouth (MA); On-site; USD 29,000 - 41,000; Full time

Job summary

South Shore Health is seeking a Patient Financial Services Representative to manage hospital and physician billing tasks in Weymouth, MA. The role supports efficient claims processing, denial management, and patient communications in a hybrid work setting after training.

The ideal candidate will have experience in healthcare billing, strong data entry and organization skills, and the ability to work across Epic and Microsoft Office tools. 8-hour day shifts, Monday–Friday.

Qualifications

• Knowledge of healthcare billing, insurance plans, codes, and reimbursement methodologies.
• Proficiency in data entry and basic computer skills, including Microsoft Office Suite.
• Excellent organizational and multitasking skills.
• Strong interpersonal and communication skills.
• Strong analytical and independent decision-making skills.

Responsibilities

• Maintains up to date knowledge of all Federal, State and Insurance specific billing regulations, policies, procedures and code sets.
• Notifies manager of any changes that would affect claim submission.
• Protect patient privacy and confidentiality in accordance with HIPAA regulations.
• Monitor payer policy updates and communicate changes that may impact billing, collections, denials, or reimbursement processes.
• Evaluate daily claim file using Claim Edit and Charge Review Work queues for submission of UB-04 and 1500 claim forms.
• Initiate claim corrections as defined payer regulation and hospital policy.
• Initiate collection of aged accounts receivable through Epic work queues while prioritizing accounts based on aging criteria.
• Collaborate with denial management staff and clinical departments to resolve account issues; generate necessary appeals.
• Document all actions taken within the EPIC notes and follow-up/denial activities; maintain records at least every 30 days.
• Escalates payer issues to Provider Representative and participates in monthly meetings.

Skills

Healthcare billing

Data entry

Microsoft Office

Communication

Analytical thinking

Hybrid/remote flexibility

Education

High school diploma

Tools

Epic

MS Outlook

SharePoint

OneDrive

Job description

South Shore Health is seeking a Patient Financial Services Representative to manage hospital and physician billing tasks in Weymouth, MA. The role supports efficient claims processing, denial management, and patient communications in a hybrid work setting after training.

The ideal candidate will have experience in healthcare billing, strong data entry and organization skills, and the ability to work across Epic and Microsoft Office tools. 8-hour day shifts, Monday–Friday.