Sr Physician Billing Associate

At Boston Children’s Hospital, the quality of our care and our inclusive hospital working environment lies in the diversity of our people. With patients from local communities and 160 countries around the world, we’re committed to reflecting the spectrum of their cultures while opening doors of opportunity for our team. Here, different talents, pursue common goals. Voices are heard and ideas are shared. Join us and discover how your unique contribution can change lives. Yours included.

Position Summary

The Senior Physician Billing Associate is responsible for the timely and accurate submission, follow-up, and resolution of physician billing charges and claims. With limited supervision, this position reviews and resolves billing issues, claim edits, denials, appeals, and outstanding balances while ensuring compliance with government and payer regulations and department policies. Epic experience is strongly preferred.

Key Responsibilities

• Review and verify patient demographic and insurance information using available technology, payer websites, and communication with third-party payers or guarantors.

• Collaborate with management and team members to obtain information needed to resolve charge edits, claim edits, denials, and appeals.

• Prepare and submit accurate insurance claims and appeals within required payer and regulatory timeframes.

• Follow up on and resolve outstanding charges and claims.

• Accept, reject, and reconcile claim runs and process payer response reports.

• Review and process guarantor overpayments according to department policies and procedures.

• Respond to inquiries from patients, guarantors, insurance carriers, departments, and foundations by phone and other forms of communication.

• Assist with training newly hired staff on processes and system navigation.

• Identify billing issues and work toward timely and accurate resolution.

• Maintain a high level of accuracy while managing daily assignments and priorities.

Minimum Qualifications

Education:

• High School Diploma or GED required.

Experience:

• Minimum of 2 years of experience in multi-specialty physician billing or equivalent medical billing experience.

• Strong knowledge of insurance benefits, coverage requirements, and payer processes.

• Experience with electronic claims processing, electronic remittance advice, electronic payment posting, and clearinghouse functions.

• Knowledge of insurance authorizations related to medical billing.

• Strong attention to detail, organization, problem-solving, and communication skills.

• Ability to work independently while also collaborating effectively as part of a team.

• Ability to manage multiple priorities and meet established deadlines.

• Ability to train and support other team members.

Schedule:

Boston Children’s Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.