Billing - Baystate Health
Category(s): Finance, Billing
Full Time / Part Time: Full-Time
The Patient Benefits Specialist is responsible for understanding and performing the functions of the Patient Accounting Department at Baystate Home Health and Hospice. Depending on the department's needs, the patient's Benefits Specialist may be responsible for home health work, hospice work, or both. This position requires knowledge of insurance verification, authorizations, and billing/collecting based on payor-specific requirements. Cross-training with all department functions is essential, and other responsibilities may be assigned at any time. Knowledge of various payor policies and regulatory requirements is critical to the successful completion of his/her job responsibilities.
1) Insurance verification of all patients in EMR using payor portals or calling the insurance companies; entering communication notes into EMR to ensure other departments are aware of patient coverage for services
2) Submit authorization requests in accordance with payor policies/requirements within the assigned service areas and provide data updates in EMR, excel spreadsheets, and other analytical tools.
3) Works with insurance companies and government payors to resolve authorization denials, including filing appeals
4) Customer service and team building: Demonstrate interpersonal skills to foster teamwork. Understand and demonstrate Baystate Home Health and Hospice Operating principles. Adheres to system and department compliance policies and applicable laws and regulations.
5) Answer, record, and relay telephone messages in a timely manner using positive customer service skills, whether speaking to patients or insurance companies.
6) Maintain effective communication with all members within the department, other departments, and contacts outside the organization
7) In a timely manner, retrieve all faxes in the e-fax system and attach documents to patients’ charts as applicable.
8) Submit claims via paper or payor portal in a timely manner by adhering to payor filing guidelines.
9) Following up with insurance companies on any rejected/denied claims for resolution.
10) Maintains balances and ensure resolution of insurance aging report. Review remittances/payments provided by insurance companies. Call insurance companies for resolution as needed and track balances on the spreadsheet and in EMR.
11) Demonstrate proficiency in the performance of computer-related activities such as word processing, spreadsheet development, and use of statistical packages and computer programs
12) Sets priorities for work assigned, separates work requiring immediate attention from regular work, and completes assignments within the timeframe needed with minimal supervision
13) Will be responsible for cross-training with all other positions in the department to help with coverage as needed
14) Ad hoc projects, as the manager requests
Required Work Experience:
Minimum two years office experience, preferably in a healthcare environment.
Skills and Competencies:
1) Proficiency in MS Word, Excel, e-mail functions, and Internet navigation; knowledge of healthcare billing preferred
2) Knowledge healthcare terminology
3) Excellent prioritizing and time management skills.
4) Excellent customer service skills
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.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
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.