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**Job Type:** Regular

**Time Type:** Full time

**Work Shift:** Day (United States of America)

**FLSA Status:** Non-Exempt

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

The Lead A/R & Billing Specialist provides support and assistance to the Revenue Cycle Manager related to all aspects surrounding the operations of the Revenue Cycle processes. Will assist with Medicare Home Health billing, Managed Care and/or all other payers following Federal and state payer guidelines and requirements. In addition, assists with the electronic billing process, account follow up, and month-end processes as needed. The lead will have knowledge of AR and SSI processes as related to Epic in order to assist the manager. They will also assist when needed in the eligibility/authorization process.

Job Description:

Essential Duties & Responsibilities including but not limited to:

• Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State and payer regulations, guidelines and requirements

• Will be a resource for Revenue Cycle employees to assist with daily problems that may arise

• Handles all correspondences and processes regarding coverage changes

• Handles all interactions with other departments/payers for escalated billing/managed care issues

• Manages Free Care day to day activities and spreadsheet

• Handles all referrals for the BILH at Home Palliative Care Program

• Manages all billing work queues and corrections needed for correct billing

• Coordinates all billing Medicare EDI transactions

• Monitors all A/R in order to maintain timely collections

• Works with payers to resolve any billing problems

• Perform all other duties as needed or directed to meet the needs of the department

Organizational Requirements:

• Maintain strict adherence to the BILH at Home Confidentiality policy.

• Incorporate BILH at Home Standards of Behavior and Guiding Principles into daily activities.

• Comply with all BILH at Home Policies.

• Comply with behavioral expectations of the BILH at Home Division.

• Maintain courteous and effective interactions with colleagues and patients.

• Demonstrate an understanding of the job description, performance expectations, and competency assessment.

• Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards

Minimum Qualifications:

Education: ● High School Diploma

Licensure, Certification & Registration: ● none

Experience: ● Prior Home Health Billing/Authorization Experience

Skills, Knowledge & Abilities: ● Knowledge of Epic EMR

• Ability to pay close attention to detail and accuracy

• Ability to work independently

• Ability to multi-task and prioritize

• Strong problem solving skills

• Good communication and interpersonal skills

Key Relationships:

Title Nature of Relationship To Position

1 Revenue Cycle Manager Works collaboratively to assist with daily activities

2 Payers Works with payers to assure timely cash flow

Work Schedule: Indicate either Yes or No as appropriate. Hours of work may be subject to change based upon the needs of the business/department.

On Call: NO Shift Rotation: NO Weekends: NO

Physical Requirements & Environment:

For each category, select ONE option from choices below by placing an X in the space to the left of the entry.

Mental and Visual Attention

a) X The position requires basic mental and visual attention much or all of the time

b) The position requires periods of concentrated mental and visual attention.

c) The position requires a high degree of mental and visual concentration.

Physical Exertion

Weight

d) X Nature of work requires lifting or moving light weight (up to 20 pounds).

e) Nature of work requires lifting or moving medium weight (over 20 and up to 75 pounds).

f) Nature of work requires lifting or moving heavy weight (over 75 pounds).

Dexterity

g) X Flow of work and nature of duties require average manual coordination.

h) Flow of work and nature of duties require above average manual coordination.

i) Flow of work and nature of duties require high manual coordination.

Range of Motion

j) X Responsibilities require average range of motion.

k) Responsibilities require above average range of motion.

l) Responsibilities require high range of motion.

Physical Conditions

m) Performance of duties allows for variation in positioning and tasks.

n) X Performance of duties requires remaining in position for prolonged periods of time.

Repetitive Motion

o) Responsibilities require occasional repetitive motion.

p) X Responsibilities require frequent repetitive motion.

q) Responsibilities require constant repetitive motion.

Working Conditions

r) X Working conditions include minimal exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.

s) Working conditions include occasional exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.

t) Working conditions include continuous exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.

Exposure to Hazardous Materials

u) X Performance of duties generally does not involve exposure to hazardous materials.

v) Performance of duties occasionally involves exposure to hazardous materials.

w) Performance of duties frequently involves exposure to hazardous materials. (Biohazardous)

Patient Care Conditions (select ALL that are applicable)

x) Responsibilities entail exposure to blood and body fluids; standard precautions must be used.

y) Responsibilities include transporting, transfer and positioning of patients.

z) Incumbent must be continuously prepared to prevent a patient fall.

Sensory Requirements (select ALL that are applicable)

aa) Performance of duties requires the ability to discern and identify colors

bb) Performance of duties requires the ability to discern sharp from dull and hot from cold

cc) Performance of duties requires the ability to hear soft and loud noises

Patient Care/Patient Contact Designation (check only one of the items listed below)

Position has a direct impact upon health outcomes of the patient.

Position facilitates the process that may impact patient access to services.

_X_ No patient care/contact, and does not facilitate the patient care process or directly impact health outcomes.

This Job Description is intended to describe the general nature and level of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive list of all responsibilities, requirements, duties and skills required of personnel so classified. Additional duties and responsibilities that are specific to the Department or Unit are identified and maintained by the Manager as an Addendum to the Job Description

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. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) 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