Patient Financial Services Specialist - Hospital Billing

Beth Israel Lahey Health; Boston (MA); Remote; USD 50,000 - 80,000; Full time

Job summary

An established industry player in healthcare is seeking a dedicated Patient Financial Services Specialist to join their team. This full-time role offers a remote work schedule and involves managing complex billing and collections for a multi-facility healthcare system. The ideal candidate will have substantial experience with Epic Hospital Billing workflows and a strong attention to detail. You'll be responsible for ensuring timely resolution of claims, interacting with insurance carriers, and maintaining accurate documentation. This position is perfect for someone looking to make a meaningful impact in a dynamic healthcare environment while enjoying the flexibility of remote work.

Qualifications

• 5+ years of accounts receivable experience required.
• Strong knowledge of Epic workflows, considered as SME.

Responsibilities

• Efficiently manage billing and collections for hospital accounts.
• Contact insurance carriers to resolve claims and denials.
• Document all actions within EPIC account notes.

Skills

Attention to detail

Epic Hospital Billing workflows

Communication skills

Problem solving

PC skills

Education

High School Diploma / GED

Tools

Epic Hospital Billing System

Job description

Patient Financial Services Specialist - Hospital Billing

Join to apply for the Patient Financial Services Specialist - Hospital Billing role at Beth Israel Lahey Health.

**Job Type:** Regular
Time Type: Full-time
Work Shift: Day (United States of America)
FLSA Status: Non-Exempt

This position is full-time with benefits and offers a remote work schedule. Under oversight of the Department Manager & Supervisor, the Patient Financial Services Specialist will be responsible for efficient and timely billing and collections of hospital outstanding balances on inpatient and outpatient accounts receivable of higher complexity within assigned work queues for a large multi-facility healthcare system with future expansion anticipated to maximize reimbursement to the health system.

Job Description

Essential Duties & Responsibilities:

• Utilizes the Epic Hospital Billing System to review and monitor accounts through the Billing, Denial, & Follow-Up work queues.
• Works assigned accounts with higher complexity (high dollar amounts, specific denial records, etc.) within Hospital Billing, Denial, & Follow-Up work queues while maintaining productivity requirements.
• Contacts insurance carriers or responsible parties to confirm payment dates, inquire about claim denials, or unresolved claims.
• Performs all hospital billing, follow-up, and denial activities necessary to obtain payment/resolution of claims.
• Reviews accounts to ensure proper billing, correct payment application, and necessary adjustments before proceeding.
• Gathers documentation needed for reprocessing/adjudication of claims.
• Escalates problematic accounts or denial trends to management within 2 days of identification.
• Documents all actions within EPIC account notes and follow-up/denial activity sections.
• Adheres to departmental policies and procedures.
• Completes required training on the hospital billing system and demonstrates proficiency to resolve assigned accounts.
• Resolves higher complexity accounts in Claims Edit work queues and resubmits claims through Epic.
• Handles paper claims processing with proper documentation.
• Communicates issues that cannot be handled to supervisors within one day.
• Researches incomplete or inaccurate claim information and escalates as needed.
• Resubmits claims for payer rejections and provides trend reports for management.

Minimum Qualifications

• High School Diploma / GED required.
• At least five (5) years of accounts receivable experience required.

Skills, Knowledge & Abilities

• Attention to detail and prioritization skills.
• Strong knowledge of Epic Hospital Billing workflows, considered as SME.
• Excellent oral and written communication skills.
• Professional telephone and email etiquette.
• Ability to interact professionally with insurance carriers, patients, and colleagues.
• Proficient in billing computer and PC skills.
• Problem solving and decision-making skills.
• Ability to work independently and efficiently.

Preferred Qualifications & Skills

• Experience in Revenue Cycle Accounts Receivable.
• Experience working with Epic.

All staff must be vaccinated against influenza and COVID-19 as a condition of employment.