Accounts Receivable; Patient Accounts - Baystate Health

Req#: R24880
Category(s): Finance, Accounts Receivable; Patient Accounts
Full Time / Part Time: Full-Time
Shift: First


Under the direction of the Patient Accounting Manager, the Collection Rep l will perform a variety of duties relating to claims submission and resolution of all third-party claims.  This will involve using multiple software programs and analyzing account transactions.  Collaborates with various BH departments and acts as the liaison between Baystate Health and the internal departments as it relates to billing and follow-up activity.  Strong written and verbal communication skills are imperative, as well as the ability to listen to and interpret payer guidelines while asking probing questions to get to the root of the denial.  Organizational and follow-up skills are key to being successful. 

Job Responsibilities: 

1)  Develop and maintain knowledge of all third-party payer requirements including all managed care contracts and state and government regulations, to ensure compliant and accurate reimbursement.

2) Develop the ability to review, research, and obtain necessary information and/or documentation from various Revenue Cycle departments to address and resolve claim edits in order to submit electronically or manually according to payer specifications, as needed. 

3) Develop skills and techniques to navigate the ever-changing payer portals, communicate with third-party payers to identify issues, and obtain necessary information in order to resolve outstanding balances.

4) Obtain supporting documentation and other information required to respond to the claim denials and secure payments.

5) Utilize web-based insurance verification systems to verify eligibility and update the information in the hospital billing systems, as needed.

6)  Document pertinent account information pertaining to claims submission, status, and resolution.

7) Establish and maintain a working relationship with third-party representatives to promote feedback and timely resolution of claims.

8) Interact and communicate effectively with inter-departmental units when necessary.

9) Develop knowledge to work and manage the various reports and logs within the assigned time frame.

10) Meet and maintains department-specific training.

11) Meet and maintains department-specific productivity and quality measurements and standards.

12) Utilize all department and health system policies and procedures as related to Patient Accounting.

Required Work Experience: 

1) 2-4 years experience as a coder in a hospital setting

2) A pre-employment test for new hires must be completed with demonstrated knowledge and experience in the inpatient/outpatient coding

Preferred Work Experience: 

1)  Additional experience is highly preferred.

Skills and Competencies: 

1) Minimum of 6-month experience in medical billing and or follow-up.

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.



GED or HiSET (Required)


Equal Employment Opportunity Employer

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.

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