64710BRAuto req ID:64710BRJob Code:403027 Staff Assistant II-Specialist Department Office Location:USA - MA - Cambridge Business Title:Medical Billing SpecialistSub-Unit:------------ Salary Grade (https://hr.harvard.edu/salary-ranges#ranges) :052Time Status:Full-time Union:55 - Hvd Union Cler & Tech Workers Basic Qualifications: High School graduate or equivalent. At least five years’ medical billing experience. Must have a working knowledge of CPT and ICD-10 codes, data entry systems for 3rd party billing, various types of payers and their reimbursement and denial patterns. Prior experience with Blue Cross/Blue Shield, Medicare, Medicare Advantage plans, MVA and/or Worker’s Compensation preferred. Thorough understanding of medical terminology. Additional Qualifications and Skills: Self-motivated individual with the ability to work both independently and as a collaborative team member. Comprehensive knowledge of accounts receivable follow-up and collection procedures. Enjoys a fast-paced environment and is flexible, energetic, and diplomatic. Proven ability to effectively handle competing priorities and multiple tasks, to take initiative and troubleshoot. Attention to detail and a commitment to delivery of quality customer service. Excellent interpersonal, organizational and communication skills. Knowledge of computers, including Microsoft Word and intermediate level Excel skills. Additional Information:

　　Harvard University requires a pre-employment reference and background screening.

　　Harvard University is unable to provide work authorization and/or visa sponsorship.

　　This position has a 90-day orientation and review period. 

　　Department:Revenue CyclePre-Employment Screening:Criminal, IdentitySchedule:

　　Monday - Friday: 8 hours each day

　　Total: 40 hours per week

　　Job Function:General Administration Position Description: DUTIES AND RESPONSIBILITIES:

　　Patient eligibility: Applies UHS eligibility policy to respond to patient/staff inquiries regarding eligibility for services at HUHS.

　　Patient coverage and COB: Maintains current knowledge of major payer provisions and regulations including student coverage, HUGHP, Medicare, and BCBS; understands and applies the concepts of primary and secondary coverage; uses available electronic resources to determine coverage; works directly with patients and insurance carriers to resolve questions of coverage; works with Medical Records staff to ensure that insurance coverage is properly documented and shared throughout the organization.

　　Charge Posting: Reviews charges in the clinical system and authorizes them for billing; troubleshoots interface errors as charges are being moved from the clinical to the billing system; manages the movement of charges from one the clinical to the billing system normally within a week of the date of service.

　　Charge Scrubbing: Reviews hold queues for claims that have failed the rules for clean claim submission and corrects errors as appropriate within filing limit restrictions.

　　Charge Process Troubleshooting: Identifies problems related to the posting of charges or payments in the clinical system (e.g., providers consistently late in submitting charges, problems associated with payment posting at time of service, inappropriate coding of services) and notifies the coder or the Medical Billing Manger as appropriate; identifies system enhancements (e.g., modifier always required, reports to facilitate finding a specific set of services) to facilitate the billing process.

　　Time of Service Payments: Posts time of service payments accuracy; manages the flow of information for term bill (including missed appointment charges), department paid services, payroll deduction as payment types on a weekly basis.

　　Claims Adjudication (payment and adjustment posting): Understands how to read an EOB; applies knowledge of claims adjudication to determining what to do with balance after insurance, patient responsibility, and when to use contractual and other adjustment types; resolves overpayments on accounts.

　　Denials and Appeals: Determines the causes for denials; directs the billing company on corrective actions to appeal denials; alerts the coder to systematic coding problems causing denials.

　　Collections: Accurately identifies accounts that need to be sent to collections; assists patients to understand the collections process; understands the process for writing off bad debt and recalling accounts from collections.

　　Customer Service: Interacts with patients in person, by phone, mail, or by secure email to address insurance coverage, payment obligation, price estimates or other needs for medical financial information; keeps the patient informed of the status of their inquiry if problem will take longer than a day to resolve; listens carefully to each patient concern to ensure that the concern is addressed.

　　Work on special projects as needed.

　　COMPLIANCE:

　　Adheres to the expectations and professional responsibilities of the department.

　　Employs the standards, practices, and procedures of the department.

　　Completes and complies with HUHS training requirements including HIPAA Privacy and Security.

　　Reports non-compliance incidents to the supervisor, manager, and/or Compliance Officer.

　　School/Unit:University Health Services EEO Statement:We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, gender identity, sexual orientation, pregnancy and pregnancy-related conditions, or any other characteristic protected by law.Physical Requirements:

　　All Harvard University Health Services (HUHS) staff and staff affiliates are considered Health Care Workers and as a condition of employment must provide documentation of the following:

　　Letter of good health from your personal health care provider.

　　TB skin test (within past 3 months) or, if known skin test positive, documentation of previous chest x-ray, information about any past treatment.

　　Documentation of immunity (positive antibody titers) for Measles, Mumps, Rubella and Varicella.

　　Proof of appropriate past immunization for Measles, Mumps, Rubella and Varicella.

　　Hepatitis B vaccine series – required for staff with possible exposure to blood or blood borne pathogens.

　　A current Flu vaccine (this season) and Covid vaccines to include the Primary series and Bivalent Booster.

　　The required medical documentation/medical clearances can often be obtained by contacting your Pediatrician, PCP, medical provider. Titers, TB Skin testing can be performed by appointment at Occupational Health facilities.

　　HUHS continues to place the highest priority on the health, safety and wellbeing of its faculty, staff and students, as well as the wider community. Being up to date with COVID vaccination, annual flu vaccination and other required medical vaccinations and documentation are required as a condition of employment at HUHS. You may claim exemption from the vaccine requirements for medical or religious reasons.

　　Job Summary: Under the direct supervision of the Medical Billing Manager and general supervision of the Director of Revenue Cycle Management the Medical Billing Specialist is responsible for accurate claims submission, accounts receivable follow-up, payment posting, EOB and COB processing, credit balance refunds, bad debt and collections. Researches problems and determines correct action steps to resolve eligibility, billing and account problems working in collaboration with an outside billing company. This may involve accessing the clinical computer system where source information resides, contacting departmental/practice representatives to obtain additional information, researching source charge entry/clinical report documents to verify information, etc. Responsible for posting billing information from the clinical management system to the billing system. Assists in the preparation of reports and analyses, providing feedback and recommendations to management related to findings.

　　Commitment to Equity, Diversity, Inclusion, and Belonging:Harvard University views equity, diversity, inclusion, and belonging as the pathway to achieving inclusive excellence and fostering a campus culture where everyone can thrive. We strive to create a community that draws upon the widest possible pool of talent to unify excellence and diversity while fully embracing individuals from varied backgrounds, cultures, races, identities, life experiences, perspectives, beliefs, and values.Benefits: We invite you to visit Harvard's Total Rewards website (https://hr.harvard.edu/totalrewards) to learn more about our outstanding benefits package, which may include:

　　Paid Time Off: 3-4 weeks of accrued vacation time per year (3 weeks for support staff and 4 weeks for administrative/professional staff), 12 accrued sick days per year, 12.5 holidays plus a Winter Recess in December/January, 3 personal days per year (prorated based on date of hire), and up to 12 weeks of paid leave for new parents who are primary care givers.

　　Health and Welfare: Comprehensive medical, dental, and vision benefits, disability and life insurance programs, along with voluntary benefits. Most coverage begins as of your start date.

　　Work/Life and Wellness: Child and elder/adult care resources including on campus childcare centers, Employee Assistance Program, and wellness programs related to stress management, nutrition, meditation, and more.

　　Retirement: University-funded retirement plan with contributions from 5% to 15% of eligible compensation, based on age and earnings with full vesting after 3 years of service.

　　Tuition Assistance Program: Competitive program including $40 per class at the Harvard Extension School and reduced tuition through other participating Harvard graduate schools.

　　Tuition Reimbursement: Program that provides 75% to 90% reimbursement up to $5,250 per calendar year for eligible courses taken at other accredited institutions.

　　Professional Development: Programs and classes at little or no cost, including through the Harvard Center for Workplace Development and LinkedIn Learning.

　　Commuting and Transportation: Various commuter options handled through the Parking Office, including discounted parking, half-priced public transportation passes and pre-tax transit passes, biking benefits, and more.

　　Harvard Facilities Access, Discounts and Perks: Access to Harvard athletic and fitness facilities, libraries, campus events, credit union, and more, as well as discounts to various types of services (legal, financial, etc.) and cultural and leisure activities throughout metro-Boston.

　　Work Format:Hybrid (partially on-site, partially remote) Work Format Details:This is a hybrid position that is based in Massachusetts. Additional details will be discussed during the interview process. All remote work must be performed within one of the Harvard Registered Payroll States, which currently includes Massachusetts, Connecticut, Maine, New Hampshire, Rhode Island, Vermont, Georgia, Illinois, Maryland, New Jersey, New York, Virginia, Washington, and California (CA for exempt positions only). Certain visa types and funding sources may limit work location. Individuals must meet work location sponsorship requirements prior to employment.About Us: Harvard University Health Services (HUHS) is a campus-based health care organization devoted exclusively to members of the Harvard community. Our work includes multi-specialty ambulatory medical care, behavioral and mental health services, and campus public health. HUHS also manages two self-funded health insurance plans, the Harvard University Group Health Plan (HUGHP, for university employees and dependents) and the Student Health Insurance Plan (SHIP, for students and dependents).