BILLING REPRESENTATIVE I - 3rd party experience strongly preferred

Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills perspectives and ideas we choose to lead. Applications fromprotected veterans and individuals with disabilities are strongly encouraged. GENERAL SUMMARY/ OVERVIEW STATEMENT: Reporting directly to the Team Supervisor and under the general direction of the Billing & Accounts Receivable Manager the Billing Representative I performs a variety of billing functions to minimize accounts receivable. This position is relied upon to work with a team to gain knowledge and expertise in billing as well as internal policies and procedures. To become an expert at utilizing electronic billing and medical retrieval systems as well as knowledge of medical billing and insurance rules and regulations to resolve accounts receivable issues.The MGPO Professional Billing Office is the central billing office for physician practices affiliated with Massachusetts General Hospital in Boston Massachusetts. PRINCIPAL DUTIES AND RESPONSIBILITIES: Achieve excellence in performance by working collaboratively with others on MGH MGPO and MGPO Professional Billing Office initiatives Supports and demonstrates the values of the Massachusetts General Hospital and the Massachusetts Physicians Organization by conducting activities in an ethical manner with integrity honesty and confidentiality. Demonstrates a positive openminded cando attitude. Represents a team perspective and willingness and enthusiasm to collaborate with others. Follows through on commitments and achieves desired results. Exhibits sound judgment obtains the facts examines options gains support and achieves positive outcomes. Maintain high standards of professional conduct at all times. Represents the MGPO Professional Billing Office at events and projects external to the organization. Enthusiastically promote a cooperative team environment to provide value to all customers. Act as a leader in creating a positive atmosphere within the team. Listen and interact tactfully diplomatically and effectively without alienating others. Account Management Demonstrate competency and a thorough understanding of all IDX modules. Specific expertise required within the IDX BAR and IDX PCS functions. Navigate patient accounts utilizing the IDX system to effectively problem solve issues. Interpret issues through effective followup within IDX PCS workfiles and requested queries. Assist in the identification of root causes. Apply transfers and/or posting of adjustments to invoices as necessary to complete the resolution of each invoice. Effectively handle telephone inquiries from insurance companies and other departments within the PBO. Gather and interpret all relevant information to help resolve issues or complaints. Document issues thoroughly. Ensure that all areas that have a direct relationship to cash flow (ie claim forms fatal and nonfatal claim edits insurance claim scrubber reports PCS workfiles) are worked as assigned by Team Supervisor. Maximize all features of the IDX PCS workfiles to ensure thorough follow up and to trouble issues. Identify and recommend adjustments to workflows within the assigned payer/specialty specific group as it relates to current AR issues. Apply knowledge of insurance rules and regulations to interpret new insurance/HCFA/HIPAA information and report potential impact. Make recommendations and communicate trends to the Team Supervisor. Meet deadlines and productivity standards for IDX/PCS workfiles including but not limited to: Insurance verification Correspondence Billing/mailing claims Working claim edits & scrubbers Third party followup including secondary billing Special projects Demonstrate proficiency with a variety of automations including but not limited to IDXBAR IDXPCS IDXTES PCIS PATCOM Microsoft Word Excel Email Voicemail and Payer Websites. Participate in continuous quality improvement efforts on an ongoing basis. Establish goals with Team Supervisor and track progress. Comply with hospital confidentiality policy. Manage special projects as assigned. Perform other duties as assigned QUALIFICATIONS: High School diploma or GED equivalent required One to Three years experience in medical billing and AR systems required. Effective communication organizational and problem solving skills Detailed working knowledge of medical terminology ICD 9 coding and CPT HCPCS required SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:Excellence in customer service skills Effective communication and interpersonal skills to successfully interact with internal and external customers Effective organizational and problem solving skills Ability to manage multiple tasks/projects simultaneously Knowledge of medical Billing insurance rules and regulations required Detail oriented Adapt positively to changes in the work setting with ease WORKING CONDITIONS: The work environment is very busy and dynamicStaff is very collaborative and work together to solve issues with particular practice issues