Patient Accounting Billing Specialist

Overview

The primary function of the Patient Accounting Billing Specialist is the daily management of an assigned portion of the accounts receivable, typically allocated based on alphabetical splits.

Responsibilities include regular and consistent billing for all payers and follow-up work on Client, inter-hospital billing, NMDP, Bluebird Bio, and Gift of Life accounts to ensure accurate reimbursement and final adjudication of claims as needed. Work pre-billing edits in the billing and scrubber systems to ensure timely submission of claims in accordance with department expectations. May also perform other duties as assigned, including but not limited to special patient accounting projects, charge entry, and cash applications.

The Patient Accounting Billing Specialist II performs analysis of persistent billing issues and recommends resolution to management and identifies trends in the billing and scrubber systems.

The specialist will have regular exposure to patient demographics, diagnostic, and billing information, and to physician information including physician numbers assigned by governmental agencies and insurance carriers.

The selected candidate must live and work from one of the New England states (ME, NH, VT, MA, RI, CT).

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life-changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations.

We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

• Reviews payments and resolves unpaid balances.
• Performs effective and timely collection activity on unpaid client accounts.
• Reviews and resolves credit on client accounts.
• Updates crossover insurance that is missing in the billing system to resolve undistributed payments.
• Triage accounts to the responsible parties in the billing system to ensure claims are addressed promptly.
• Updates issues grid with examples of impacted accounts.
• Operates on multiple systems as assigned. Will use Epic, FISS, Connex, Nehen, and Fin Thrive for processing and follow-up activity for Inpatient/Outpatient claims as assigned.
• Keeps informed on updates to billing requirements, editing, and payer policies affecting billing.
• Informs supervisor of changes to billing regulations.
• Meets department productivity and qualitative standards.
• Works account and claim edits in the hospital billing system.
• Works rejections, edits and accounts in the incomplete folder in the claim scrubber system (Fin Thrive), consistent with the department standards.
• Performs analysis of persistent billing issues and recommends resolution to management.
• Assists the supervisor with coaching and training new or existing billing specialists as needed.
• Identifies trends in the billing and scrubber systems.
• Assists with troubleshooting and resolving issues in the absence of the P/A Billing Specialist.
• Assists the Supervisor in recording minutes for staff meetings.
• Meets department productivity and qualitative standards.
• Handles complex billing issues.
• Reassigns staff assignments in their absence.
• Assists in maintaining billing information on the shared drive for staff easy access.
• Collaborates with JV partners to resolve coding and ADT issues.
• Performs other duties as assigned.

None; coaches and trains new staff, available as a strong resource.

• Minimum Education: High school diploma required; bachelor’s degree preferred.

• Minimum Experience: 3-5 years of previous billing experience required.
• Experience working with various software applications, including Microsoft Office and various billing software preferred.
• Experience with patient account applications and procedures preferred.