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Summary:

Schedule: Monday-Friday 8a-430pm

Under the direction of the Receivables Supervisor and Lead; identifies denials/appeals, makes appropriate system changes, completes balance adjustments, initiates write-offs, updates account registration/insurance information, documents work-in-process, obtains materials to complete the collection and/or appeals process and mentors colleagues. Other related duties as required.

Job Responsibilities:

**1)** Reviews all accounts/invoices for collection/appeal activities and takes appropriate action based on findings. Prioritizes accounts through the Enterprise Task Management system (ETM).

**2)** Reviews all denied claims for third party payer on "Explanation of Benefits" and remittance advises and takes appropriate action based on findings.

**3)** Appeals claims from third party carriers with additional documentation as needed for appropriate reimbursement.

**4)** Initiates "reimbursement inquiries" to Reimbursement Department for definitive answers to specific issues.

**5)** Initiates charge corrections as needed, based on findings from Reimbursement Issues and Appeals and or Coding.

**6)** Accurately records and files all third party payer information, reimbursement inquiries and appeals in process.

**7)** Interacts effectively with external contacts. Keeps supervisor advised of issues and changes in volume that can effect meeting unit or department expectations

**8)** Accurately records productivity and other information required for established reports.

**9)** Completes assigned projects with advanced productivity and efficiency while maintaining a high degree of accuracy.

**10)** Mentors, shares information with, and trains colleagues.

**11)** Performs other duties as assigned, including assisting other units or departments.

Required Work Experience:

**1)** Knowledge of current third party billing and collection regulatory guidelines and requirements

**2)** Two or more years third party billing experience

Preferred Work Experience:

**1)** Knowledge of Centricity Business system

Skills and Competencies:

**1)** Ability to work in a fast paced environment

Education:

GED or HiSET (Required)

Certifications:

Equal Employment Opportunity Employer

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.