Remote-Ready Hospital Billing & Denial Specialist (Epic)

South Shore Health; États-Unis; Hybride; USD 31 000 - 44 000; Plein temps

Résumé du poste

South Shore Health is seeking a Patient Financial Services Representative in Weymouth, MA, to manage insurance claims and payment processes using the EPIC Billing System. You will submit claims, follow up on denials, and communicate with insurance companies to resolve discrepancies.

The role emphasizes accurate data entry, adherence to HIPAA, and timely, professional communication with patients and payers. Hybrid or remote work options may be available on weekdays.

Qualifications

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

Responsabilités

• Keeps up-to-date knowledge of Federal, State and Insurance billing regulations and policies.
• Notifies manager of changes affecting claim submission and protects patient privacy under HIPAA.
• Monitors payer policy updates and communicates implications for billing, denials, or reimbursement.
• Evaluates daily claim files for submission of UB-04 and 1500 forms.
• Initiates claim corrections as per payer regulations and hospital policy.
• Resubmits claims through EPIC after external claim edits and pursues aged AR collections.
• Contacts insurance companies to resolve outstanding balances for unresolved/ incomplete accounts.
• Collaborates with denial management, clinical departments, and patient access to resolve issues.
• Generates technical appeals for account resolution and documents actions in EPIC notes.

Connaissances

Healthcare billing

Insurance plans

Coding knowledge

Data entry

Microsoft Office

Organization skills

Communication skills

Analytical thinking

Independent decisions

Formation

High school diploma

Outils

Epic

Claim Edit

Charge Review

Mytime payroll

Outlook

SharePoint

OneDrive

Description du poste

South Shore Health is seeking a Patient Financial Services Representative in Weymouth, MA, to manage insurance claims and payment processes using the EPIC Billing System. You will submit claims, follow up on denials, and communicate with insurance companies to resolve discrepancies.

The role emphasizes accurate data entry, adherence to HIPAA, and timely, professional communication with patients and payers. Hybrid or remote work options may be available on weekdays.