The Biller reports to the Manager of the Billing Unit and is responsible for the timely and accurate submission of billed claims for both MGH and BWH. The Biller will work with the Billing team to supply accurate and required information to achieve acceptance with first time submission. The Biller must be able to perform in a high volume and fast paced production environment with a high degree of accuracy and productivity. This individual should have the ability to take responsibilities and perform required tasks independently as well as in a team environment.
1. Use both legacy and bolt-on systems effectively to perform all job responsibilities
2. Submit a high volume of claims (both primary and secondary) on a daily basis
3. Ensure accuracy of claim form data, required for claims acceptance and payment
4. Validate address completion, provider number requirements, member id requirements, filing limit restrictions and all coding requirements (HCPCS, CPS, diagnoses, and procedures included)
5. Identify and resolve claim deficiencies and reference registration processes and system functionality in order to resolve and resubmit timely
6. Effectively update legacy system patient information and comment/post transaction codes appropriately in order to provide as much information as possible to other units
7. Contact workers compensation insurance companies to verify accuracy of address, adjustor information, claim number, and timely medical records ordering and retrieval for all workers compensation inpatient claims
8. Ensure and audit daily claims for legacy systems
9. Utilize system reports to verify that volumes and dollars match
10. Accurately enter a high of volume of data into database for tacking purposes
11. Perform quality assurance to entered date to ensure accuracy as they are relied upon as source of truth and reported to Senior Management monthly
12. Identify specialty claims and initiate alternate billing processes
13. Manually bill dental claims and accurately transfer information from UB92 to proprietary form
14. Identify interim claims and review/research as necessary to determine if billing is required
15. Prepare negative charge adjustment request documentation to work with revenue control
16. Review and research all returned mail and patient survey information for accuracy
17. Utilize all resources possible to obtain updated information including payer websites and NEHENLite to verify eligibility whenever possible
18. Initiate the correct action required whenever necessary and update all legacy systems and resubmit in a timely fashion
19. Maintain and monitor the medical record review process to ensure timely return of requests and distributions
20. Utilize tracking logs and sign-off sheets in order to maintain special requests for medical records that cannot be done using our systems
Qualifications:
1. High school diploma or equivalent required
2. Two years previous patient accounting experience strongly preferred
3. Possess basic knowledge and understanding of UB92 and 1500 claim forms and data fields
4. Strong interpersonal skills required
5. Ability to effectively communicate with employees throughout the PHS network
6. Ability to identify problems and issues within daily bill drops
7. Basic knowledge of MS Office, most importantly Excel and Access, is required
8. Knowledge of hospital billing required
9. Attention to detail a must
10. Ability to multi-task required
11. Accurately and productively perform high volume output on a daily basis
12. Previous experience with hospital billing systems a plus
Salary/Benefits: Salary commensurate with experience
Partners HealthCare offers a comprehensive benefits package,
including a choice of six medical plans, two dental plans,
prescription drug and vision coverage, generous Paid Time Off,
disability coverage, retirement plans, flexible spending
accounts, and tuition reimbursement.
Job Location: Boston, MA
Job Number: 6321
Company URL: http://www.partners.org
Company Profile:
Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Partners HealthCare is a network of integrated hospitals and physicians providing cutting-edge patient care, teaching, and research. Over 3,000 professionals work behind the scenes to help keep Partners at the forefront of medicine, including those in Information Systems, Finance, Human Resources, Development, Real Estate, Legal Counsel, Business Planning, and other administrative capacities. Enjoy the benefits of a strong, stable organization; the largest health system in New England and the largest non-government employer in Massachusetts.
Partners Healthcare System is an Equal Opportunity Employer.
