Patient Accounts Billing Representative

Established in 1980, the Greater Lawrence Family Health Center, Inc. (GLFHC) is a multi-site, mission-driven, non-profit organization employing over 700 staff whose primary focus is providing the highest quality patient care to a culturally diverse population throughout the Merrimack Valley. Nationally recognized as a leader in community medicine (family practice, pediatrics, internal medicine, and geriatrics), GLFHC has clinical sites in Lawrence, Methuen, and Haverhill and is the sponsoring organization for the Lawrence Family Medicine Residency program.

GLFHC is currently seeking a Patient Accounts Billing Representative. This position follows department and payer processes to ensure all claims are submitted in a timely, accurate, and compliant manner while maximizing reimbursement opportunities. We are seeking a candidate with strong health insurance coverage and benefits knowledge who understands how to navigate patient insurance plans, payer requirements, claim denials, and reimbursement processes.

The ideal candidate will be experienced in analyzing and reviewing outstanding accounts receivable, resolving claim rejections and denials, preparing appeals and corrected claims, and performing consistent follow-up with insurance payors to resolve billing issues. This role requires someone who is highly organized, persistent, detail-oriented, and comfortable handling frequent email communication, phone calls, and ongoing payer follow-up.

• Reviews patient eligibility utilizing practice management function or payer websites to determine correct payer to be billed for specific dates of service.
• Prepares claim data according to department and payer regulations in order to produce a “clean” claim.
• Prepares, reviews and transmits claims timely to payers, works EDI rejections.
• Posts charges, payments and denials in practice management system accurately.
• Works denials and prepares appeals, resubmits claims and performs compliant actions to resolve open accounts receivable. Reports unusual trends to supervisor.
• Utilizes insurance and practice management online systems to complete all required tasks such as eligibility, claim status and claim correction.
• Processes insurance and patient refunds as necessary.
• Answers patient and department calls. Assist in telephone inquiries regarding patient statements. Establish payment arrangements when appropriate.
• Reconcile all batch totals at day end to ensure accuracy of totals posted and transactions on charge capture. Identify and correct any discrepancies prior to opening any future batch.

Qualifications:

• 1-2 years of medical billing experience ,medical claims follow-up, or medical billing certification.
• Knowledge of CPT, ICD10 coding and compliance preferred.
• Familiar with Medical terminology
• Combination of education and equivalent experience will be considered.

GLFHC offers a great working environment, comprehensive benefit package, growth opportunities and tuition reimbursement.