Specialty Billing Coordinator, Lahey Health Shared Services

Lahey Clinic Hospital, Inc.; Burlington (MA); Remote; USD 33,000 - 44,000; Full time

Job summary

Lahey Clinic Hospital, Inc. seeks a Specialty Billing Coordinator to manage international and executive client billing and AR.

The role collaborates with Revenue Cycle and clinical leaders to ensure compliant claim submissions and timely payments, while providing client estimates and addressing payer issues. Minimum requirements include a Bachelor’s degree and 5 years in a Patient Financial Services setting, with supervisory or lead experience.

Qualifications

• CMS coding, billing and compliance knowledge required.
• Experience in patient financial services and revenue cycle processes.
• Bachelor's degree or equivalent combination of education and experience.

Responsibilities

• Oversee AR for International and Executive Client Accounts with revenue-cycle oversight.
• Analyze receivables and ensure performance aligns with leadership expectations.
• Provide client estimates and coordinate collections for international and executive billing.
• Respond to payer requests and resolve billing issues in collaboration with leadership.

Skills

CMS coding

Billing & collections

Analytical skills

Communication skills

Education

Bachelor's degree

Tools

Epic

Job description

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The Specialty Billing Coordinator will support the Lahey Health Shared Services Department. The role will be based in Burlington, MA and will offer the ability to work primarily remotely once fully trained.

Job Description: Under the managerial oversight of the Manager of Customer Service and Director of Executive – International Health the Specialty Billing Coordinator serves as a primary point of contact for Executive clients and International payers of Lahey Hospital & Medical Center (LHMC). The Patient Financial Services (PFS) Coordinator’s overall responsibility is to manage the Client Account Services, Revenue and Payments for both departments. This includes but is not limited to, registration, estimates, collections for self-pay services, account initiation and coordination, claims submission, fee schedule maintenance, denials and customer service for hospital and professional billing.

Essential Responsibilities include:

• Overseeing AR for International and Executive Client Accounts, this includes: Works closely with Revenue Cycle Team to ensure accurate compliant claim submissions, denial management and AR follow up for both hospital and professional charges.
• Analyzes outstanding account receivable and credits and ensures that these are maintained at the levels expected by Revenue Cycle Leadership.
• Analyze reimbursement to insure accurate payments Work with clinical leadership as needed to coordinate client accounts and services.
• Responds to Payer requests relative to reimbursement issues, rejections, and or billing problems.
• Establishes and maintains effective working relationships with Lahey revenue cycle, clinical departments and administrative leadership in regards to the Executive and International Client Billing.
• Providing estimates for clients within the International Department and ensuring collection of payments. This includes collections for the Health Safety Net surcharge which is mandated under The State of Massachusetts.
• Interacts with designated Government agencies (International accounts) and company personal (Executive Health) to ensure compliance with federal and local regulations, timely payments and management of AR.
• Works with leadership in regards to internal policy and procedures to ensure optimized efficiency.
• Communicate with clinical and revenue leadership regarding analysis of services and discovered issues resulting in denials, or process improvements needed for workflow.
• Works as liaison to the Executive Client companies and the International patients regarding complex billing issues that may need escalation to the appropriate management team with LHMC.
• Works closely with Revenue Cycle Analyst team to optimize the use of Epic and increase efficiency.

Minimum Qualifications:

• Education: Bachelor degree. In the absence of a Bachelor’s degree, 6 years of experience over and above the experience requirement listed below.
• Experience: Five years experience in a Patient Financial Services organization. Three years supervisory experience in a Patient Financial Services organization, or four years in a Lead position within Patient Financial Services organization of similar size and scope.

Skills, Knowledge & Abilities:

Comprehensive understanding and knowledge of the Center for Medicare and Medicaid Services (CMS) coding, billing and compliance requirements. Working knowledge of patient financial services activities including the HCPCS coding system, the ICD-9 coding system, revenue, claims, denials and collection practices. Must have a high level of analytical skill, process improvement abilities, problem solving skills and ability to manage a large work force within a large healthcare environment. Computer skills to include use of complex revenue cycle systems, Microsoft, and other basic computer skills are a requirement. Excellent verbal and written communication skills required. Presentation Skills required.

Pay Range:

$24.15 - $32.50. The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled At Beth Israel Lahey Health, we are driving the change in health care that Massachusetts wants and needs. Our culture promotes continuous learning, growth, innovation and a sense of belonging. We make it a priority to offer comprehensive compensation and benefits and help you achieve a healthy and balanced life. While you're busy caring for and supporting our patients, we take care of you.