Billing Specialist II

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POST DATE 9/16/2016
END DATE 12/31/2016

Partners Community Physicians Organization(PCPO) Lawrence, MA

Lawrence, MA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)


Reporting directly to the team Supervisor and under the general direction of the Business Office Manager, the Billing Specialist II performs a variety of billing functions to minimize accounts receivable. This position works within a team to gain knowledge and expertise in billing as well as internal policies and procedures. To become an expert at utilizing electronic billing and medical retrieval systems as well as knowledge of medical billing and insurance rules and regulations to resolve accounts receivable issues.

Demonstrate competency and a thorough understanding of rules and regulations for all HMO, government and commercial insurance plans.

Knowledge with appeals process based on payer specific issues.

Demonstrate proficiency with a variety of automations, including by not limited to Medic, Allscripts, GE Centricity, EMR, Microsoft Word, Excel, Outlook and payer websites. Navigate patient accounts utilizing the practice management system to effectively problem solve issues.

Posting adjustments, applying or moving monies as necessary to complete the resolution of each invoice.

Effectively handle telephone inquiries from insurance companies and other departments within the CBO. Gather and interpret all relevant information to help resolve issues or complaints. Document issues thoroughly in the practice management system by using appropriate rejection code

Ensure that all areas that have a direct relationship to cash flow (ie claim forms, fatal and non-fatal claim edits, insurance claim scrubber reports) are worked as assigned by Team Supervisor.

Meet deadlines and productivity standards for CBO, including but not limited to:
1. Insurance verification
2. Correspondence
3. Billing/mailing claims
4. Working claim edits & scrubbers
5. Third party follow-up including secondary billing

6. Refund initiation process

7. Special projects

Perform other duties as assigned

3 years experience in medical billing and AR systems required


Ability to assume a high level of responsibility and autonomy

Ability to interact with people from all levels of the organization

Strong analytical and problem solving skills

Detailed working knowledge of medical terminology

Strong computer skills, particularly Microsoft Excel

Adapt positively to changes in the work setting with ease

Demonstrate proficiency with MEDIC, CENTRICITY, ALLSCRIPTS, EMR, Microsoft Word, Excel, Outlook and Payer Websites. Equal Opportunity Employer