Lead Patient Billing & Denials Specialist

Lowell Community Health Center; Lowell (MA); On-site; USD 63,861,000 - 86,402,000; Full time

Job summary

The Lowell Community Health Center seeks a Patient Accounts Representative Lead to support daily billing operations, manage denials, payments, and A/R activity, and ensure accurate revenue cycle processes.

You will mentor the payment posting team, analyze payer guidelines, and implement workflow improvements while collaborating with clinical and billing staff to improve financial outcomes.

Qualifications

• Healthcare reimbursement processes, third-party payer procedures, and collection techniques.
• Federal, commercial, and state medical reimbursement regulations.
• Medical terminology and coding compliance.

Responsibilities

• Lead payment posting, denial management, and A/R activities.
• Coach and coordinate daily operations of the payment posting and denials team.
• Monitor and resolve discrepancies, patterns impacting balances and payment activity.
• Audit financial transactions, identify overpayments/underpayments, and issue refunds as needed.
• Research payer reimbursement guidelines, coding requirements, filing limits, and billing regulations.
• Develop training materials and workflow enhancements for the billing staff.
• Recommend updates to claims processes and practice management systems.
• Escalate concerns to clinical stakeholders, contract coordinators, and Revenue Cycle leadership.
• Act as the subject matter expert for billing, payment posting, denials and A/R processes.
• Assist with specialized billing workflows such as Dental Billing, OB Global Billing, Out-of-Office Services, Vision Care, Behavioral Health, Specialty Services.

Skills

Independent

Results-driven

Self-starter

Communication skills

Interpersonal skills

Problem-solving

Collaboration with medical staff

Job description

The Lowell Community Health Center seeks a Patient Accounts Representative Lead to support daily billing operations, manage denials, payments, and A/R activity, and ensure accurate revenue cycle processes.

You will mentor the payment posting team, analyze payer guidelines, and implement workflow improvements while collaborating with clinical and billing staff to improve financial outcomes.