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As a health care organization, Lahey Hospital and Medical Center is committed to providing high quality, safe patient care. As an employer, Lahey is committed to ensuring a professional environment where every staff member is encouraged to excel. With a team approach to care, physicians and nurses at Lahey work side-by-side with allied health professionals, medical technologists, and administrative and support staff to deliver on our mission. Lahey encourages learning and growth at all levels, and we offer competitive salaries and benefits.
Appl Support SpecialistApply Now Job ID 145422 Date posted 10/31/2017
Under the managerial oversight of the Manager of Revenue Support, and where responsibilities are performed independently within established department policies and procedures, this position is responsible for PB reporting, claims set up/processing, remittance set up/processing, credit and denials analysis.
Essential Duties & Responsibilities including but not limited to:
1. Serves as the primary support contact for PFS revenue operational leads and serves as a liaison between PFS PB revenue operation leads, PFS PB Staff and third parties.
2. Responsible to assist with revenue operations as they relate to build decisions, in-depth analysis of denials, credits, workflows, data collection, report details, claims and remittance set up, logic and processing and other technical issues.
3. Monitors outstanding accounts receivable and credits and ensures that they are maintained at the levels expected by management. Analyzes work queues and other system reports and identifies denial/non-payment trends and reports them the Manager of Revenue System Operations and the Director of Professional Billing.
4. Develops and distributes weekly, monthly and ad hoc reports needed by PFS revenue operational leads and finance.
5. Collects and reports information to the Manager of Revenue Support regarding potential system enhancement needs and system breaks/fix issues.
6. Provides in depth knowledge and assists in determining best system build options and functionality that will help improve operational workflows and system usage and understands the choices involved in application configuration
7. Assists in the development of streamlined operational workflows, policies and procedures, and coordination of end user training prior to build change implementation.
8. Analyzes new functionality in releases to determine how it should be used and works with PFS PB revenue operation leads.
9. Participates in testing all aspects of the system prior to upgrades and new implementations.
10. Maintains thorough knowledge of EDI claims and remittances, payor billing requirements and policies.
11. Maintains thorough knowledge of regulatory changes in the healthcare environment.
12. Provides and promotes ideas geared toward process improvements within the Central Billing Office.
13. Completes projects and research as assigned.
1. Incorporates Lahey Clinic Guiding Principles , Mission Statement and Goals into daily activities.
2. Complies with all Lahey Clinic Policies.
3. Complies with behavioral expectations of the department and Lahey Clinic.
4. Maintains courteous and effective interactions with colleagues and patients.
5. Demonstrates an understanding of the job description, performance expectations, and competency assessment.
6. Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
7. Participates in departmental and/or interdepartmental quality improvement activities.
8. Participates in and successfully completes Mandatory Education.
9. Performs all other duties as needed or directed to meet the needs of the department
Education: Bachelor degree. In the absence of a Bachelors degree, 3 years of experience over and above the experience requirement listed below.
Experience: 3 years experience in a Patient Financial Services organization.
Skills, Knowledge & Abilities: Comprehensive understanding and knowledge of the Center for Medicare and Medicaid Services (CMS) coding, billing and compliance requirements. Working knowledge of patient finanicial services activities including the HCPCS coding system, the ICD-9 coding system, revenue, claims, denials and collection practices. Must have a high level of analytical skill, process improvement abilities, problem solving skills Computer skills to include use of complex revenue cycle systems, Microsoft, and other basic computer skills are a requirement. Excellent verbal and written communication skills required. Presentation Skills required.
About Lahey Health
At Lahey Hospital & Medical Center, as one of the world's premier health care organizations, we provide superior health care leading to the best possible outcome for every patient. We exceed our patients' high expectations for service each day. We also help advance medicine through research and the education of tomorrow's health care leaders
We care for our patients with compassion and openness, unsurpassed expertise, a drive for continuous learning improvement, and with respect, caring, teamwork, excellence and commitment to doing our personal best.
Join our team and our mission of excellence by applying today!
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