When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Job Type : Regular

Regular

Scheduled Hours : Work Shift :

Work Shift :

Day (United States of America)Responsible for clean and timely submissions of 837I and UB claims to insurance carriers to ensure maximum reimbursement for the Hospital Health System.

Job Description :

Essential Duties & Responsibilities including but not limited to :

1) Responsible for the timely submission of clean 837I and / or UB claims.

2) Follows up on 277CA rejections within assigned WQ’s until acceptance validation has been received by the payer.

3) Interacts by telephone and / or mail with payers relative to claims processing.

4) Resubmits claims when necessary, utilizing a variety of EDI technologies and relevant billing systems to reduce aged rejections.

5) Reviews, validates, and updates coverage changes on hospital accounts within assigned WQ to avoid denials (. COB, invalid payer, etc)

6) Resolves accounts within Hospital Billing Claim Edit WQ’s due to invalid account information(., wrong subscriber ID format, patient demographics, etc)

7) Sorts, prepares and processes incoming and outgoing paper UB and insurance correspondence.

8) Maintains detailed documentation on individual account activity such as correspondence, phone conversations, and the like.

9) Resolves specific payer / plan claim edits in assigned WQ’s generated from within Epic and the external Clearinghouse Vendor.

10) Establishes relationships and maintains open communication with third party payor representatives in order to resolve claims issues.

11) Identifies internal and / or external billing issues and notifies Supervisor and / or Manager.

12) Alerts Supervisor and / or Manager to procedural and / or system changes based upon payer billing requirements

13) Accessing payer websites for eligibility, claim status, possible online corrections, and viewing both the most current EDI and paper billing regulations.

Minimum Qualifications :

Education : High School Diploma or equivalent.

Licensure, Certification & Registration : N / A

FLSA Status : Non-Exempt

Non-Exempt

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) and COVID-19 as a condition of employment.

about this requirement.

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

Last updated : 2024-05-01