• P/A Biller Spec I

    Location US-MA-Brookline
    Job Posted Date 4 months ago(6/20/2019 1:59 PM)
    Job ID
    2019-15839
    Category
    Finance/Accounting/Patient Billing
    Type
    full time
    Grade
    17
  • Overview

    Located in Boston and the surrounding communities, Dana-Farber Cancer Institute brings together world renowned clinicians, innovative researchers and dedicated professionals, allies in the common mission of conquering cancer, HIV/AIDS and related diseases. Combining extremely talented people with the best technologies in a genuinely positive environment, we provide compassionate and comprehensive care to patients of all ages; we conduct research that advances treatment; we educate tomorrow's physician/researchers; we reach out to underserved members of our community; and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

    The primary function of the P/A Biller Specialist is the daily management of an assigned portion of the accounts receivable, typically allocated based on payer and alphabetical splits. Basic responsibilities include regular and consistent billing or follow-up work on outstanding third-party claims, denial management, verification of accurate reimbursement, and correction and/or reprocessing of claims as necessary. The Billing Specialist should remain in full compliance with all departmental, institutional and regulatory policies and procedures. Confidentiality is a key function of this role.  The Specialists will have regular exposure to patient demographics, diagnostic and billing information.  Additionally, they will have exposure to physician information including physician numbers assigned by governmental agencies and insurance carriers.  The Specialists may also perform other duties as assigned, including but not limited to, special patient accounting projects, charge entry, and cash applications.

    Responsibilities

    • Daily management of the assigned portion of the accounts receivable including:
      • Reviewing claim denials and working with internal departments to provide information necessary to have the claim adjudicated by third-party payers
      • Managing follow up efforts with third-party payers via websites, intermediaries, mail, email, fax and phone
      • Comparing payments on open A/R accounts to the related payer contracts to ensure proper payment and adjustment amounts have been posted
      • Maintaining open credit balances to ensure proper adjustments have been made or processes third-party refunds when necessary
      • Fulfills documentation requests from payers, specifically medical records, claims, itemized bills, Letters of Agreements, proof of timely filing, appeals and other requests as needed 
    • Willingness to identify and escalate issues and trends to management
    • Flexibility to work on ad-hoc projects that serve the team, while maintaining assigned portion of the A/R
    • Open to learning new workflows and processes while providing constructive feedback based on past experiences and forward-thinking ideas
    • Acquire and maintain working knowledge of payer policies, behaviors and updates as assigned
    • All other duties and requests as assigned  Ability to operate out of multiple systems as assigned. (ie claim scrubber, billing system, email, payer portals)

    Qualifications

    • Bachelor’s degree preferred or a minimum of 2 years of experience required
    • Experience within an office setting, preferably a hospital billing office
    • Performs primary duties above as directed and requires moderate supervision
    • Experience working with various software applications, including Microsoft Office and various billing software preferred. Experience with patient account applications and procedures preferred
    • Some knowledge of third party regulations
    • Some knowledge of patient accounting regulations
    • Well organized, detail-oriented and dependable
    • Excellent/professional communications skills including both verbal and written skills
    • Team player, self-starter-leader, ability to establish priorities

     





    Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other groups as protected by law.

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