Third party biller
Job in
Weymouth, Norfolk County, Massachusetts, 02188, USA
Listed on 2026-01-01
Listing for:
South Shore Health
Full Time
position Listed on 2026-01-01
Job specializations:
-
Healthcare
Healthcare Administration, Medical Billing and Coding
Job Description & How to Apply Below
If you are an existing employee of South Shore Health then please apply through the internal career site.
Requisition Number: R-20964
Facility: LOC
0014 - 549 Columbian Street 549 Columbian Street Weymouth, MA 02190
Department Name: SHS Patient Accounts
Status: Full time
Budgeted
Hours:
40
Shift: Day (United States of America)
Accumulate data from Patient Access and Health Information Management for the purpose of submitting compliant third party insurance and physician claims. Initiate all collection calls for payment on aged accounts receivable up to the point of self-pay collections. Generates reports for responsible insurance plans and maintains online collection worklists and online claims editing software for maximum efficiency. Ability to decipher reimbursement schemes for assigned insurance’s to complete the revenue cycle.
Responsibilities- Notifies manager of any changes that would effect claim submission
- Initiate claim corrections as defined by insurance regulation and hospital policy.
- Evaluate unresolved accounts weekly, contact outside departments as needed and submit status to manager weekly to resolve unbillable accounts.
- Unresolved accounts require insurance company contact by phone, e‑mail or designated web site to resolve outstanding balances.
- Collaborate with denial management staff for accounts that require clinical intervention for an appeal process.
- Generate technical appeals as needed for account resolution.
- Provide to manager a detail account history for any account that is considered uncollectable.
- All work list accounts must have collection efforts documented every 30 days unless otherwise notified.
- Accumulate at the beginning of each month or as requested a listing of unresolved/open accounts with aging greater than 120 days for manager review.
- Review credit balance accounts in assigned worklist, review payment history for accuracy. Make a determination if a refund is needed and forward to the appropriate refund agent for resolution.
- Initiate Insurance retractions as needed for payments posted to the Hospitals Unlocated Cash Accounts. Incorrect payments that require a check will be forwarded to the appropriate refund agent for resolution.
- Generate phone calls or letters as needed to obtain necessary insurance or other related information, prior to an account being placed in self pay.
- Obtain proper verification of predefined patient demographic information and maintain documentation in order to verify identity.
- Uses the API payroll system to enter time worked, sick days, vacations and holidays.
- Uses Meditech to access and run reports.
- Uses Lotus Notes as a communication tool.
- Access provider web sites for verification of accounts.
- Successfully answers safety questions in the annual mandatory education packet.
- Makes a neat, organized work environment.
- Adheres to respiratory etiquette guidelines.
- Other duties as required.
- Attends and participates in staff meetings, in‑service meetings and other activities as related to job performance.
- Attend seminars, workshops and training sessions offered by providers.
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