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Professional Billing, Billing Specialists

Company: Lowell General Hospital - Main Campus
Location: Lowell
Posted on: March 18, 2023

Job Description:

Under general supervision, this position is responsible for accounts receivables resolution, including, but not limited to, eligibility verification, billing edits, claim edits, payer follow-up, correspondence review, corrected claims, appeals, reimbursement verification, and remittance research for assigned scope of receivables

Performs day-to-day activity to ensure that all information for proper billing is complete and accurate; billing to assigned payers is transmitted or mailed within a timely manner.
Conducts follow-up on outstanding account balances with assigned receivables and takes appropriate action for resolution.
Responsible for researching and handling rejections, including understanding why a claim rejected, how it must be fixed, and what party is financially responsible. Must initiate any corrective action, including referral to the Team Lead or Supervisor when appropriate.
Reviews, evaluates and processes appeals through research and resubmission to appropriate third party with complete and accurate supporting documentation.
Responsible for the processing of adjustments due to denials and contractual requirements.
Resolves assigned accounts in a timely and accurate manner, maximizing reimbursement in compliance with assigned payer and government regulations, and provider organization and department policies and procedures.
Maintains up-to-date knowledge of federal and state regulations and payer requirements along with annual updates to CPT/ICD-10 coding guidelines.
Interacts on a daily basis over the phone, on the web and through correspondence with payers. Establishes working relationships with payer representatives to facilitate processing of claims.
Regular interaction with other departments of the provider organization using electronic system tools to resolve accounts, including Patient Access, Revenue Integrity, Coding, Medical Records, Utilization Review, Hospital Departments, Physician's Offices, and other Administrative teams.


A high school diploma or GED completion is required.
Completion of a medical terminology course and understanding of CPT and ICD diagnosis coding preferred.
HFMA CRCR a plus.
Epic certifications a plus.

What We Offer:
Not only is Lowell General Hospital an exceptional place to work, offering a culture of recognizing and valuing employees, we provide amazing opportunities for our staff:

We promote from within whenever possible and want to see staff grow and advance in their careers
We have competitive salaries & benefits that start on day one, generous tuition reimbursement and 403 (b) retirement plan with company match
Free on-campus parking

About Lowell General Hospital:

Lowell General Hospital is an independent, not-for-profit community hospital serving the Greater Lowell area and surrounding communities. With two primary campuses located in Lowell, Massachusetts, we are the second-largest community hospital in Massachusetts. We have the latest state-of-the-art technology and a full range of medical and surgical services for patients, from newborns to seniors.

Tufts Medicine Lowell General Hospital is an Equal Opportunity Employer.

Location: Tufts Medicine Lowell General Hospital - Professional Billing Service
Schedule: Full Time, Days%7217033% %%admin%%

Keywords: Lowell General Hospital - Main Campus, Lowell , Professional Billing, Billing Specialists, Other , Lowell, Massachusetts

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