Revenue Cycle Operations Pro: Denials & Eligibility

BILH Performance Network; Northern (KY); Hybrid; USD 33,000 - 45,000; Full time

Job summary

Beth Israel Lahey Health in Charlestown, MA seeks a Revenue Cycle Operations Specialist to perform a broad range of medical billing functions across professional and hospital claims. You will research and resolve denials, posting adjustments, and ensure accurate billing in Epic systems.

Responsibilities include managing front-end edits, payer rejections, and retroactive coverage changes, training staff, and collaborating with departments to improve workflows and reduce denials.

Qualifications

• Strong knowledge of third-party payor reimbursement, eligibility verification process, and government and payor compliance rules.
• Experience in registration billing and denial management environment.
• Experience in training and staff development preferred.

Responsibilities

• Identify and resolve registration, coverage, and eligibility issues in Epic billing queues.
• Post manual adjustments with appropriate codes and handle high-threshold adjustments for review.
• Resolve external clearinghouse edits and payer rejections to ensure proper reimbursement.
• Mentor and train AR staff on registration procedures and Epic workflows.

Skills

Payor reimbursement knowledge

Education

Associate degree or equiv

Tools

Epic Resolute (Billing)

Job description

Beth Israel Lahey Health in Charlestown, MA seeks a Revenue Cycle Operations Specialist to perform a broad range of medical billing functions across professional and hospital claims. You will research and resolve denials, posting adjustments, and ensure accurate billing in Epic systems.

Responsibilities include managing front-end edits, payer rejections, and retroactive coverage changes, training staff, and collaborating with departments to improve workflows and reduce denials.