The primary function of the P/A Follow-Up Specialist is the daily management of an assigned portion of the accounts receivable, typically allocated based on payer and alphabetical splits. Basic responsibilities include regular and consistent billing or follow-up work on outstanding third-party claims, denial management, verification of accurate reimbursement, and correction and/or reprocessing of claims as necessary. The Billing Specialist should remain in full compliance with all departmental, institutional, and regulatory policies and procedures. Confidentiality is a key function of this role. The Specialist will have regular exposure to patient demographics, diagnostic and billing information. The Specialist may also be called upon to perform other duties as assigned.

This position's work location is fully remote with occasional time on-campus in Brookline Place. The selected candidate may only work remotely from a New England state (ME, VT, NH, MA, CT, RI).

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Under direct supervision, performs tasks related to the daily management of the assigned portion of the accounts receivable:

• Reviews claim denials and works with internal departments to provide information necessary to have the claim adjudicated by assigned third-party payer.
• Performs follow-up efforts with third-party payers via websites, intermediaries, mail, email, fax, and phone.
• Compares payments on open A/R accounts to the related payer contracts to ensure proper payment and adjustment amounts have been posted.
• Evaluates open credit balances to ensure proper adjustments have been made or processes third-party refunds when necessary.
• Fulfills documentation requests from payers, specifically, medical records, claims, itemized bills, Letters of Agreements, proof of timely filing, appeals and other requests as needed.
• Works out of multiple systems as assigned. (i.e., claim scrubber, billing system and payer portals).
• Performs other duties as assigned.

• Minimum Education:
  • High school diploma or GED required.
• Minimum Experience:
  • 1-2 years in a hospital and/or physician office with insurance claims follow-up experience required.
  • Consideration will be given to candidates with experience in Access Management (scheduling, registration, financial clearance), coding and denial management.
• License/Certification/Registration:
  • N/A

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

• Knowledge of software applications, including Microsoft Office and billing software.
• Some knowledge of hospital / physician billing software.
• Some knowledge of third-party regulations.
• Some knowledge of patient accounting regulations.
• Ability to work independently and under direct supervision.
• Ability to respond to clients and proactively anticipate their needs.
• Ability to set a positive example for others by following high ethical standards.
• Ability to seek ways to support team efforts while contributing to overall organizational success.

At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong. As relentless as we are in our mission to reduce the burden of cancer for all, we are equally committed to diversifying our faculty and staff. Cancer knows no boundaries and when it comes to hiring the most dedicated and diverse professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.

Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other groups as protected by law.

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