Accounts Receivable Denial Specialist

What We Offer:

• Purpose-Driven Work Make a meaningful impact in the lives of individuals families and communities throughout Western Massachusetts.
• Professional Growth Access ongoing training mentorship career development and advancement opportunities across one of the regions largest behavioral health organizations.
• Supportive Team Culture Join a collaborative workplace guided by our HEART values: Humanity Empowerment Accountability Respect and Teamwork.
• Stability & Opportunity Build your career with a well-established organization serving Western Massachusetts since 1938.
• Comprehensive Benefits Generous PTO 403(b)educational assistance medical dental vision employee assistance programs and more.
• Certified Great Place to Work Work for an organization recognized for creating a positive and engaging employee experience.

What You Will Do:

• Follows up on all assigned claims (at 45 days 60 days and 90 days) to ensure timely reimbursement and bring claims to closure.
• Reviews denied claims for accuracy to ensure coding billing rates and modifiers are accurate before sending appeals or reconsiderations to payers.
• Investigates claims with no payer response to ensure the payer received the claim.
• Navigates payer websites and appeal processes as defined by all payers including commercial and government payers including Mass Health Tricare Medicare Medicaid and Medicare Advantage plans.
• Reviews and finds trends or patterns of denials to prevent errors.
• Assists and confers with the EHR Matrix team and Billing Manager concerning any coding or modifier setup issues.
• Responsible for identifying missing payments overpayments and analyzing credits on accounts. Initiates refund requests for credit and overpayments.
  

Who You Are:

• High School Diploma or GED required.
• Minimum of 5 years of experience in a medical billing department with strong AR account follow-up appeals and Behavioral Health codes and modifier knowledge required.
• Demonstrated knowledge of and experience in healthcare medical billing claims processing follow-up and appeals required.
• Carelogic EHR with working knowledge and experience is a strong preference but not required.
• Must be a critical thinker with strong research analytical and mathematical skills required.
• Current knowledge of HIPAA compliance 42 CFR requirements and changing regulatory guidelines.
• Extensive comprehension in utilizing email search engines and the Internet with the ability to effectively use payer websites.
  
  

PAY: $23 - $27/hour (depending upon experience)

This is a REMOTE position - must be able to work 8am-4pm Eastern

We Hire for HEART!

Since 1938 BHN has delivered high-quality culturally responsive behavioral health care building deep roots in Western Massachusetts while expanding our impact in communities throughout the state. Our core valuesHumanity Empowerment Accountability Respect and Teamworkguide how we lead serve and support one another. If youre ready to bring your skills and experience to a mission-driven organization where your work can make a meaningful difference wed love to hear from you.

How do I apply

If you are interested in this opportunity please click Apply for Job below or visit our website and click on Browse All Jobs to apply! You can also email your resume to Elisa Auker at

BHN is committed to social justice and diversity and strongly encourages diverse candidates to apply. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability or veteran status.

Required Experience:

IC