Beth Israel Lahey Health

Provides comprehensive administrative support to physicians including patient scheduling and coordination. | Requires high school diploma or GED with 3-5 years of related experience and proficiency in Microsoft Office. | When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The Division of Pulmonary, Critical Care, and Sleep Medicine at Beth Israel Deaconess Medical Center (BIDMC) provides compassionate care for patients with critical illness, lung, chest, airway conditions, and sleep-related disorders. This position is located at BIDMC in the Longwood area of Boston, MA. The work schedule is Monday to Friday from 8:30am - 5:00pm. This role may be eligible for a hybrid schedule, up to two days remote, following six months of satisfactory performance. Job Description: Provides administrative support to physicians in their clinical, academic, research and leadership roles. Essential Responsibilities: Answers and screens telephone calls . Takes accurate messages or directs call to appropriate person. Greets and directs patients, families, visitors and staff. Responds to requests in a timely manner and provides clear, accurate information within scope of knowledge and authority. Updates patient demographic and insurance information as necessary and obtains specialist referrals for all patient appointments. Schedules patient appointments utilizing scheduling tools and resources. Coordinates and communicates ancillary appointments and procedures working with other hospital staff as needed. Obtains patient information and materials as needed from referral sources. Prepares patient records for clinical activities and maintains patient records for physicians. Acts as liaison with other departments and external customers in a calm and supportive manner. Handles confidential information appropriately and explains policies and procedures when necessary. Maintains physician's administrative and clinical calendars. Types correspondence, manuscripts and documents that may require complex formatting. Composes routine correspondence. Transcribes letters and patient notes as needed for physicians and/or facilitates notes and letters in CCC system. Composes routine correspondence. Prepares and distributes materials for meetings and committees. Actively assists and supports licensed practitioners by queuing prescriptions for renewal and performing the initial review of medication listings for accuracy in the electronic medical record (Web OMR). Required Qualifications: High School diploma or GED required. Associate's degree preferred. 3-5 years related work experience required. Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access. Competencies: Written Communications: Ability to communicate clearly and effectively in written English with internal and external customers. Oral Communications: Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers. Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations. Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members. Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations. Physical Nature of the Job: Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally. Pay Range: $21.63 - $29.11 The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law. As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment. More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger. Equal Opportunity Employer/Veterans/Disabled

Review and code denied professional service claims, analyze and correct coding errors, resolve denials, communicate with insurance payors, and support billing and coding teams. | High school diploma with recognized coding certification (CPC, CPC-A, or CCS-P), 1-2 years billing/coding experience, strong organizational and problem-solving skills, and ability to work independently. | Job Type: Regular Time Type: Full time Work Shift: Day (United States of America) FLSA Status: Non-Exempt When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. • This is a remote based position* Identifies, reviews, and interprets third party payments, adjustments and coding denials for all professional services. Reviews provider documentation in order to determine appropriate coding and initiate corrected claims and appeals. Duties include hands on coding, documentation review and other coding needs for ICD-9, ICD-10. Works directly with the Billing Supervisor and Coding Manager to resolve complex issues and denials through independent research and assigned projects. Job Description: Essential Duties & Responsibilities including but not limited to: Coding Responsibilities: 1. Provides review and/or coding of any coding related denied professional services for appropriate use of CPT, ICD-9, ICD-10, HCPCS, Modifier usage/linkage. 2. Periodic review of codes, at least annually or as introduced or required. 3. Reviews and analyzes rejected claims and patient inquiries of professional services, and recommends appropriate coding corrections via paper or electronic submission to the Follow up Team. 4. Reports coding trends and issues to the coding supervisor for education within the coding department and/or physician education. 5. Confers regularly with the Coding Department through regular departmental staff meetings, on-on-one meetings to review and discuss coding denials and education. 6. Maintains certification requirements for coding. Follow Up Responsibilities: 1. Monitors days in A/R 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 to the Billing Supervisor. 2. Responds to incoming insurance/office calls with professionalism and helps to resolve callers’ issues, retrieving critical information that impacts the resolution of current or potential future claims. 3. Establishes relationships and maintains open communication with third party payor representatives in order to resolve claims issues. 4. Reviews claim forms for the accuracy of procedures, diagnoses, demographic and insurance information, as well as all other fields on the CMS 1500. 5. Reviews and corrects all claims/charge denials and edits that are communicated via Epic, Explanation of Benefits (EOB), direct correspondence from the insurance carrier or others and uses information learned to educate PFS and office staff to reduce future denials and edits of the same nature. Initiates claim rebilling or corrections and obtains and submits information necessary to ensure account resolution/payments. 6. Identifies invalid account information (i.e.: coverage, demographics, etc.) and resolves issues. 7. Evaluates delinquent third party accounts and processes based on established protocols for review, payment plan or write-off. 8. Reviews/updates all accounts for write-offs and refunds. 9. Keeps informed of all federal, state, and managed care contract regulations, maintains working knowledge of billing mechanics in order to properly ascertain patients’ portion due. 10. Completes all assignments per the turnaround standards. Reports unfinished assignments to the Billing Supervisor. 11. Handles incoming department mail as assigned. 12. Attends meetings and serves on committees as requested. 13. Maintains appropriate audit results or achieves exemplary audit results. Meet productivity standards or consistently exceeds productivity standards. 14. Provides and promotes ideas geared toward process improvements within the Central Billing Office. 15. Assists the Billing Supervisor with the resolution of complex claims issues, denials and appeals. 16. Completes projects and research as assigned. 17. Provides feedback and participates as the coding representative for the Patient Financial Services Department on the Revenue Cycle teams. Secondary Functions: 1. Enhances professional growth and development through in-service meetings, education programs, conferences, etc. 2. Complies with policies and procedures as they relate to the job. Ensures confidentiality of patient, budget, legal and company matters. 3. Exercises care in the operation and use of equipment and reference materials. Performs routine cleaning and preventive maintenance to ensure continued functioning of equipment. Maintains work area in a clean and organized manner. 4. Refers complex or sensitive issues to the attention of the Billing Supervisor to ensure corrective measures are taken in a timely fashion. 5. Observes irregularities in the cash/denial posting process and reports them immediately to the Billing Supervisor. 6. Accepts and learns new tasks as required and demonstrates a willingness to work where needed. 7. Assists other staff as required in the completion of daily tasks or special projects to support the department’s efficiency. 8. Performs similar or related duties as assigned or directed. Education & Professional Development: 1. Researches and stays updated and current on CMS (HCFA), AMA and Local Coverage Determinations (LCD’s), or Local Medical Review Policies (LMRP's) to ensure compliance with coding guidelines. 2. Stays current on quarterly CCI Edits, bi-monthly Medicare Bulletins, Medicare's yearly fee schedule, Medicare Website, and specialty newsletters. 3. Makes guidelines available via, paper, on-line access, web access, or any other means provided by manager. Organizational Requirements: 1. Maintain strict adherence to the Lahey Health Confidentiality policy. 2. Incorporate Lahey Health Standards of Behavior and Guiding Principles into daily activities. 3. Comply with all Lahey Health Policies. 4. Comply with behavioral expectations of the department and Lahey Health. 5. Maintain courteous and effective interactions with colleagues and patients. 6. Demonstrate an understanding of the job description, performance expectations, and competency assessment. 7. Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards. 8. Participate in departmental and/or interdepartmental quality improvement activities. 9. Participate in and successfully completes Mandatory Education. 10. Perform all other duties as needed or directed to meet the needs of the department. Minimum Qualifications: Education: High School diploma or equivalent, plus additional specialized training associated attainment of a recognized Coding Certificate Licensure, Certification & Registration: CP (Certified Professional Coder through AAPC), CPC-A (Certified Professional Coder - Apprentice through AAPC), or CCS-P (Certified Coding Specialist Physician Based through AHIMA) Experience: 1-2 years of experience in billing, coding, denial management environment related field. Skills, Knowledge & Abilities: • Ability to work independently and take initiative • Good judgment and problem solving skills • Excellent organizational skills • Ability to interact and collaborate effectively and tactfully with staff, peers and management. • Ability to promote team work through support and communication. • Ability to accept constructive feedback and initiate appropriate actions to correct situations. • Ability to work with frequent interruptions and respond appropriately to unexpected situations. As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment. More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger. Equal Opportunity Employer/Veterans/Disabled