• Verify payor eligibility and update practice management system with corrections or changes as necessary. Contact patient(s) who show ineligible for insurance coverage, confirm new coverage and update as required. Inform patient of payment responsibility of uninsured. Determine patient responsibility for office testing or procedures and communicate to patient to collect payment/arrange payment plan.
• Check patient(s) previous balances on each patient during verification. Contact patient to inform them of balance due at time of visit.
• Verify PCP election accuracy and contact patient if PCP is inaccurate for resolution.
• Process all necessary precertification requests for all diagnostic imaging, procedures and other special testing via telephone, fax and various external health plan websites.
• Compile clinical data, including: physician notes, patient history, test results and other clinical information from Electronic Medical Record and other sources to respond to each payor’s precertification requirements.
• Coordinate peer-to-peer review with providers when required from payors for precertification.
• Complete all FMLA, disability, sports, school, out of work and return to work forms in a timely manner.
• Complete all HEDIS requests.
• Process all medical record requests from patients, insurance companies, attorneys, etc. Inform request of fee, if applicable, and assure payment received prior to record release.
• Cover front desk as needed during vacation, sick calls, high patient volumes, etc.

• High School Diploma/GED equivalent
• 3 years plus of current medical office experience
• Strong customer service
• Attention to detail
• Experience with working with Payors
• Proficient in Microsoft Office Suite products

What We Offer:

Not only is Lowell General Hospital an exceptional place to work, offering a culture of recognizing and valuing employees, we provide amazing opportunities for our staff:

• Competitive salaries & benefits
• 403(b) retirement plan with hospital match
• Opportunities for growth
• Tuition reimbursement
• Free on-campus parking

About Lowell General Hospital:

This is a great opportunity to be part of a 3-time Magnet Recognized, community hospital. Lowell General Hospital is an independent, not-for-profit community hospital serving the Greater Lowell area and surrounding communities. With two primary campuses located in Lowell, Massachusetts, we are the second-largest community hospital in Massachusetts and are proud to be a Magnet hospital. The American Nurses Credentialing Center (ANCC) honored Lowell General Hospital with Magnet Recognition for excellence in nursing care for a 3rd designation. The Magnet Recognition Program recognizes healthcare organizations that are dedicated to nursing excellence, professionalism and patient-focused care. It is the highest level of recognition an organization can receive for providing the very best quality in patient care. Only 2% of hospitals have attained their 3rd Magnet designation.

We are a proud member of Tufts Medicine and in collaboration with the medical community it is our promise to provide our patients with Complete connected care SM

Tufts Medicine Lowell General Hospital is an Equal Opportunity Employer.