Claims Edit Coder Jobs in Massachusetts (NOW HIRING)

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 region's 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:
Under the direct supervision of the Revenue Cycle Director, the Revenue Cycle Supervisor is responsible for overseeing and optimizing revenue-related operations. This role involves in-depth analysis of both incoming and outgoing revenue streams, as well as the preparation of advanced, complex technical and analytical reports, including key performance indicators for the assigned team. The Revenue Cycle Supervisor will directly manage one of the following teams: Accounts Receivable, Claims Submission, Site Coordination, or Payment Posting. The primary objective of this role is to enhance the efficiency, quality, and financial performance of the Revenue Cycle function.

• Supervises daily activities of the denial and follow-up team to ensure timely and effective claim resolution by conducting regular team meetings, provides performance feedback (Individual One on One), trains and mentors staff on payer guidelines, denial codes, appeal processes, program guidelines, and customer service standards.
• Monitors aged claims, follow-up buckets and ensures proactive follow-up with insurance companies, government payers, and third-party administrators and ensures it is done consistently and timely.
• Oversees the identification, categorization, and root cause analysis of denied claim to ensure appropriate and timely appeal submission, reconsiderations, or corrected claim and done timely, while developing and implementing denial prevention strategies based on trend and root cause analysis.
• Maintains accurate documentation of follow-up and appeal activities for audit readiness, monitors and reports on Key metrics such as Denial rate, appeal success rate, Days in accounts receivable (A/R), and claims touch per days per staff.

Who you are:

• High School Diploma or GED required. Associate's Degree or 3-5 years prior health-care revenue cycle analyst experience (if no degree) preferred.
• 2-3 years' management experience required.
• Mass Behavioral Health knowledge a plus.
• Ability to schedule, meet and maintain daily and monthly routines, as well as preserve the integrity of the EHR.
• Ability to identify team goals and evaluate progress, in addition to coaching team members to achieve these goals.
• Extensive knowledge of medical insurance and an overall understanding of managed care products (HMO, PPO, ACO, etc.) as well as billing and collections with CPT, ICD-10, and HCPC coding and medical terminology.
• Understanding and ability to read and edit 5010 HIPAA transaction standards including, but not limited to, 837, 999, 277, and 835 file types.
• Proficient in Microsoft Office products with strong skills in Excel (VLOOKUPs, pivot tables, formulas, etc.).
• Strong analytical and problem-solving skills.

Pay range: $72,000 - $75,000 per year
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 values-Humanity, Empowerment, Accountability, Respect, and Teamwork-guide how we lead, serve, and support one another. If you're ready to bring your skills and experience to a mission-driven organization where your work can make a meaningful difference, we'd 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 at www.bhnworks.org and click on "Browse All Jobs" to apply!
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.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
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