Beth Israel Lahey Health · 2 days ago
Billing & Certified Coding Specialist I (Remote)
United States
Full-time
Remote
Entry Level
$21/hr - $28.26/hr
1+ years expBeth Israel Lahey Health is a growing healthcare organization, and they are seeking a Billing & Certified Coding Specialist I. The role involves reviewing and coding denied professional services, analyzing rejected claims, and ensuring compliance with coding guidelines.
Family & CareEducationHealthcareHospitalProfessional ServicesElder CareHealth CarePrimary and Urgent CareTraining
Responsibilities
Provides review and/or coding of any coding related denied professional services for appropriate use of CPT, ICD-9, ICD-10, HCPCS, Modifier usage/linkage
Periodic review of codes, at least annually or as introduced or required
Reviews and analyzes rejected claims and patient inquiries of professional services, and recommends appropriate coding corrections via paper or electronic submission to the Follow up Team
Reports coding trends and issues to the coding supervisor for education within the coding department and/or physician education
Confers regularly with the Coding Department through regular departmental staff meetings, on-on-one meetings to review and discuss coding denials and education
Maintains certification requirements for coding
Monitors days in A/R and ensures that they are maintained at the levels expected by management. Analyzes work queues and other system reports and identifies denial/non-payment trends and reports them to the Billing Supervisor
Responds to incoming insurance/office calls with professionalism and helps to resolve callers’ issues, retrieving critical information that impacts the resolution of current or potential future claims
Establishes relationships and maintains open communication with third party payor representatives in order to resolve claims issues
Reviews claim forms for the accuracy of procedures, diagnoses, demographic and insurance information, as well as all other fields on the CMS 1500
Reviews and corrects all claims/charge denials and edits that are communicated via Epic, Explanation of Benefits (EOB), direct correspondence from the insurance carrier or others and uses information learned to educate PFS and office staff to reduce future denials and edits of the same nature. Initiates claim rebilling or corrections and obtains and submits information necessary to ensure account resolution/payments
Identifies invalid account information (i.e.: coverage, demographics, etc.) and resolves issues
Evaluates delinquent third party accounts and processes based on established protocols for review, payment plan or write-off
Reviews/updates all accounts for write-offs and refunds
Keeps informed of all federal, state, and managed care contract regulations, maintains working knowledge of billing mechanics in order to properly ascertain patients’ portion due
Completes all assignments per the turnaround standards. Reports unfinished assignments to the Billing Supervisor
Handles incoming department mail as assigned
Attends meetings and serves on committees as requested
Maintains appropriate audit results or achieves exemplary audit results. Meet productivity standards or consistently exceeds productivity standards
Provides and promotes ideas geared toward process improvements within the Central Billing Office
Assists the Billing Supervisor with the resolution of complex claims issues, denials and appeals
Completes projects and research as assigned
Provides feedback and participates as the coding representative for the Patient Financial Services Department on the Revenue Cycle teams
Enhances professional growth and development through in-service meetings, education programs, conferences, etc
Complies with policies and procedures as they relate to the job. Ensures confidentiality of patient, budget, legal and company matters
Exercises care in the operation and use of equipment and reference materials. Performs routine cleaning and preventive maintenance to ensure continued functioning of equipment. Maintains work area in a clean and organized manner
Refers complex or sensitive issues to the attention of the Billing Supervisor to ensure corrective measures are taken in a timely fashion
Observes irregularities in the cash/denial posting process and reports them immediately to the Billing Supervisor
Accepts and learns new tasks as required and demonstrates a willingness to work where needed
Assists other staff as required in the completion of daily tasks or special projects to support the department’s efficiency
Performs similar or related duties as assigned or directed
Qualification
Required
High School diploma or equivalent, plus additional specialized training associated attainment of a recognized Coding Certificate
CP (Certified Professional Coder through AAPC), CPC-A (Certified Professional Coder - Apprentice through AAPC), or CCS-P (Certified Coding Specialist Physician Based through AHIMA)
1-2 years of experience in billing, coding, denial management environment related field
Ability to work independently and take initiative
Good judgment and problem solving skills
Excellent organizational skills
Ability to interact and collaborate effectively and tactfully with staff, peers and management
Ability to promote team work through support and communication
Ability to accept constructive feedback and initiate appropriate actions to correct situations
Ability to work with frequent interruptions and respond appropriately to unexpected situations
Company
Beth Israel Lahey Health
Beth Israel Lahey Health Center offers patient care, urgent care, assisted living, and research and education services.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Robert Fields
Chief Clinical Officer and Executive Vice President
Recent News
2026-01-25
Boston Globe
2025-11-24
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