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Third Party Reviewer at Partners HealthCare(PHS)

Posted in Other 30+ days ago.

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Type: Full Time
Location: Somerville, Massachusetts

Job Description:

As a not-for-profit organization, Partners HealthCare is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Womens Hospital and Massachusetts General Hospital, Partners HealthCare supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.

Were focused on a people-first culture for our systems patients and our professional family. Thats why we provide our employees with more ways to achieve their potential. Partners HealthCare is committed to aligning our employees personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal developmentand we recognize success at every step.

Our employees use the Partners HealthCare values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk, and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.

The Reviewer functions under the general supervision of the Unit Manager. This position is responsible for the review, follow-up and collection/resolution of the Medicare receivables.

Review assigned accounts by contacting Medicare to ensure timely resolution of accounts.

Create updates and document information relating to the financial status of accounts in the hospital billing systems.

Contact patients and/or other third party representatives to secure additional information pertaining to reimbursement of accounts.

Process rejected/adjusted claims through Medicare FISS system. And various payer websites.

Communicates effectively with other PHS employees throughout the system.

Performs all other duties and assignments as requested.


Minimum of three years experience as a patient account representative in a hospital or medical office setting. High school diploma.

Excellent interpersonal skills and strong team player. Knowledge of third party payer contracting language, terms and medical terminology.

Competency with Microsoft Word and Excel.

Partners HealthCare is an Equal Opportunity Employer & by embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law.