PFS Denial Specialist I Professional Billing

Location: Burlington, MA
Job ID: 176827-1A
Date Posted: Sep 6, 2022
Category: Specialist

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Job Description

Welcome To

Welcome to Shared Services, our team uses a coordinated approach to delivering administrative and operational services across Lahey. Our Shared Services colleagues leverage resources across the organization to ensure we provide high-quality, high-value care to the communities we proudly serve.  The Shared Services team includes colleagues who focus on business and network development, legal services, facilities and real estate, human resources, information technology, finance, philanthropy and marketing and communications.


About the Job

The Denials Specialist position is a key role in our expansive Patient Financial Services Group.  As a Denials Specialist, you will identify, review and interpret third party payments, adjustments and denials with a focus on reviewing and interpreting denials and facilitating first and second level appeals to insurance.   We have positions on the professional and hospital billing side!


This role can be a great position for someone with a certificate in medical billing and coding, claims experience, billing, EOB or insurance verification experience.  The ideal candidate will have experience with insurance appeals and denials, a working knowledge of third-party payer reimbursement, eligibility verification process and government and payer compliance rules.


We have a great career ladder trajectory and internal opportunities with positions such as Denials Specialist II, Revenue Billing Specialist and Revenue Cycle Analyst.  You will collaborate with colleagues across the organization, impact critical organizational revenue streams and gain valuable experience working with our Epic EHR system.  We offer flexible working hours (shifts start as early as 7-3:30PM) with a comprehensive benefit program. 


Minimum Qualifications and Experience:

Required Experience: 2+ years of Healthcare experience, specifically in a claims, billing, EOB or insurance verification .                      

Required Education: High School Diploma

Preferred Licensure, Certification & Registration:  Medical Billing Certification 


Keywords: denials, appeals, claims, medical billing and coding, EOB, write-off, PFS, Medicaid, Blue Cross Blue Shield, Medicaid


About Us

Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve.  Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health.  Beth Israel Lahey Health Performance Network is a unified joint contracting and population health management organization, jointly governed by participating physicians and hospitals.

Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.