Billing Representative Ii Pbo

GENERAL SUMMARY/ OVERVIEW STATEMENT: Reporting directly to the Team Supervisor and under the general direction of the Billing & Accounts Receivable Manager the Billing Representative II performs a variety of billing functions to minimize accounts receivable and enhance collection performance. This position is relied upon to work on any activity within the team with little or no direct supervision. Utilizes electronic billing and medical retrieval systems as well as in depth knowledge of medical billing and insurance rules and regulations to resolve accounts receivable issues. Assist Team Supervisor with specified duties. 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: 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 Perform all aspects of the Billing Representative I position at a consistently high degree of proficiency. This entails a complete understanding of all department policies and procedures to execute all billing tasks with minimal direct supervision. This representative is expected to be a leader within the team in productivity teamwork efficiency communication and patient care. Act with minimal supervision notice or direction to identify and resolve problems and complete work. Work the most sensitive IDX workfiles projects and/or accounts and provide immediate feedback to Team Supervisor on changes or modification that need to be communicated to appropriate Liaison/department. Apply knowledge of insurance rules and regulations to interpret new insurance/HCFA/HIPAA information and report potential impact. Utilize experience and expertise to efficiently and effectively determine the correct course of action on each account/project. 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. Apply transfers and/or adjustments to invoices as necessary to complete the resolution of each invoice. Request necessary data as appropriate to resolve issue and trends once identified within their workfiles and follow through on resolutions to completion. Represent the department in meetings with other PBO or MGH staff as well as with Insurance Representatives. Coordinate data to complete special billing projects based on contractual obligations and regulatory demands. Meet deadlines and productivity standards for IDX/PCS workfiles including but not limited to: Insurance verification Referral Management Correspondence & phone inquiries Billing/mailing claims/appeals Working claim edits & scrubbers Third party followup including secondary billing & rejections 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 Payor 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 Associates degree or equivalent recommended. Experience may be substituted for a degree. Three years experience in high volume medical billing and Billing/Accounts Receivable systems required. IDXBAR & IDXPCS knowledge preferred Effective communication organizational and problem solving skills Detailed working knowledge of medical terminology ICD 9 coding and CPT HCPCS preferred. Epic and or Anesthesia/Oral Max Billing experience preferred 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 Demonstrated proficiency with a variety of automations including but not limited to IDXBAR IDXPCS PATCOM Meditech INVISION LMR Microsoft Word Excel Email and electronic data processing skills Established as a dynamic and positive team player able to work independently and in a group/team setting Knowledge of medical Billing insurance rules and regulations required Detail oriented Adapt positively to changes in the work setting with ease WORKING CONDITIONS: Office environment The work environment is very busy and dynamicStaff is very collaborative and work together to solve issues with particular practice issuesMassachusetts 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.