Revenue Cycle Specialist: Billing & Denials Expert

Beth Israel Lahey Health; Boston (MA); On-site; USD 33,000 - 44,000; Full time

Job summary

Beth Israel Lahey Health is seeking a Revenue Cycle Operations Specialist to resolve registration, coverage, and eligibility issues across professional and hospital billing. The role requires proactive denial prevention, payer follow-up, and expert use of Epic Resolute.

Ideal candidates will have an Associate degree or equivalent, 3 years in a billing/denial management environment, and strong knowledge of payor reimbursement and eligibility processes.

Qualifications

• Strong knowledge of third-party payor reimbursement and eligibility verification.
• Experience with government and payor compliance rules is required.
• Training and staff development experience is preferred.

Responsibilities

• Resolve registration, coverage, and eligibility issues to prevent denials.
• Process professional and hospital billing edits and denials with payer follow-up.
• Post manual adjustments with approved codes and escalate when needed.
• Manage external clearinghouse edits and payor rejections promptly.
• Train staff and provide ongoing education on Epic workflows and policies.
• Collaborate with departments and payors to identify trends and改善 processes.
• Participate in meetings and provide operational billing support to physician groups.

Skills

Payor reimbursement

Eligibility verification

Regulatory compliance

Staff training

Education

Associate degree or equivalent experience

Tools

Epic Resolute

Job description

Beth Israel Lahey Health is seeking a Revenue Cycle Operations Specialist to resolve registration, coverage, and eligibility issues across professional and hospital billing. The role requires proactive denial prevention, payer follow-up, and expert use of Epic Resolute.

Ideal candidates will have an Associate degree or equivalent, 3 years in a billing/denial management environment, and strong knowledge of payor reimbursement and eligibility processes.