Revenue Cycle Specialist III

East Boston Neighborhood Health Center Corporation•Revere, MA

8d•$22 - $32

About The Position

Thank you for your interest in a career at NeighborHealth, formerly East Boston Neighborhood Health Center! As one of the largest community health centers in the country, NeighborHealth is proud to serve the greater Boston area with a strong commitment to the health and well-being of our patients and communities. Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential support staff who keep our operations running smoothly — every role at NeighborHealth is vital. Together, we’re advancing medicine and delivering the best care experience for our patients and community! Interested in this position? Apply online and create a personal candidate account! Current Employees of NeighborHealth - Please use our internal careers portal to apply for positions. To learn more about working at NeighborHealth and our benefits, please visit out our Careers Page . Time Type: Full time Department: Patient Accounts All Locations: 300 Ocean Avenue – Revere Position Summary: Revenue Cycle Specialist performs a wide spectrum of billing functions to minimize accounts receivable and enhance collection performance. Utilize electronic medical billing systems as well as in depth advanced knowledge of medical billing and insurance rules and regulations to resolve accounts receivables issues. This position serves as the primary resource on complex issues and specified duties.

Requirements

High School Diploma or equivalent.
3+ years of experience in a medical billing
3+ years of Epic PB Resolute experience required
Demonstrate proficiency with a variety of automations, including but not limited to Epic, Microsoft Word, Excel, Email and electronic data processing skills
Working knowledge of insurance rules and regulations
Proficiency in PC software (i.e database)
Ability to manage multiple tasks/projects simultaneously
Strong organizational skills and effective interpersonal skills
Excellent communication skills (verbal and written)

Nice To Haves

Proficiency level understanding of Medical Billing, ICD and CPT coding preferred.

Responsibilities

Meet deadlines and productivity standards for Epic work queues, including but not limited to Insurance verification (Epic RTE), Denials (research root cause, identify trends, correct, appeal), Claim Edits (ensure clean claim submission), Transaction history (track claim submission and payor response).
Work the priority Epic work queues, projects and/or accounts and provide immediate feedback to management.
Utilize payor websites to research policies and coverage eligibility for use in claim adjudication, trend identification, and application for process improvement.
Utilize MS Office, with an emphasis on Excel to document, trend, and communicate workflow assignments, trends, and information vital to performance.
Apply transfers and/or adjustments to invoices as necessary to complete the resolution of each invoice.
Knowledge of ICD-10, Modifiers,Revenue Codes, HCPCS and CPT codes.
Coordinate data to complete special billing projects based on contractual obligations and regulatory demands.
Apply knowledge of insurance rules and regulations to interpret new insurance/HCFA/UB/HIPAA information and report potential impact.
Work along NeighborHealth Patient Accounts Leadership with various payors as part of the contact group responsible for updates and information required to assist others in the organization.
Participation in various projects and testing of updates for evaluation and implementation.
Maintains good interpersonal relationships with stakeholders internal and external to the department.
Provides feedback to assist NeighborHealth management in developing strategies to improve financial service operations.