Third Party Specialist

Beth Israel Deaconess Medical Center

Job Description

Efficiently and accurately completes the intermediate level Accounts Receivable tasks to resolve both pre- and post-billing and payment issues. Ensures the highest level of collection and the lowest level of denials.

Essential Responsibilities:
Researches denied accounts, partially paid or denied line items. Determines appropriate appeal, contractual adjustments or bills to next payer.
Follows up with the payers regarding claims that have not been paid and escalates as needed.
Efficiently researches and appropriately resolves billing edits.
Reviews payer rejections and makes corrections to ensure payer acceptance of claims.
Independently analyzes and resolves credit balance and documents actions in the billing system.
Required Qualifications:High School diploma or GED required. Associate's degree preferred.
1-3 years related work experience required.
Proficient key boarding skills for data entry and ability to navigate between more than one computer system.
Ability to work independently as well as part of a team; ability to work effectively in a fast paced environment.
Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
Preferred Qualifications:Two or more years of customer service experience and/or basic knowledge of third party coverage, registration and billing.
Competencies:Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.
Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.
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