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Children's Hospital Boston Senior Physician Billing Associate in Boston, Massachusetts

70018BRJob Posting Title:Senior Physician Billing AssociateDepartment:PO Cooperative Billing OfficeAutoReqId:70018BRStatus:Full-TimeStandard Hours per Week:40 Job Posting Category:AdministrationJob Posting Description:This hybrid role on the Cash Management Team in the Shared Service Center is responsible for Account Receivable for Physician Billing at BCH. The candidate will be responsible for resolving insurance credit balances and various cash management functions as indicated below.

This Senior Physician Billing Associate will be responsible to:

  • Prepare and submit accurate retraction /overpayment requests to payer within required timeframes and in accordance with government/payer regulations and requirements.

  • Analyze and reconcile accounts in order to submit accurate retraction/overpayment requests

  • Review and verify all demographic and insurance information utilizing available technologies, payer websites, or by phone contact with third-party payers or guarantors.

  • Collaborate with management and peers to ensure all required information is obtained for resolution of charge edits, claim edits, denials, and appeals in a timely manner, while adhering to government/payer regulation and department policy/procedures.

  • Prepare and submit accurate insurance claims and appeals to payer within required timeframes and in accordance with government/payer regulations and requirements.

  • Resolve outstanding charges and claims responding timely and accurately for resolution of outstanding balance while adhering to department policies/procedures.

  • Review and process guarantor overpayments per department policies and procedures.

  • Respond to inquiries received via telephone and other correspondence from patients/guarantors, insurance carriers, departments/foundations as needed.

To qualify, you must have:

  • High School diploma or equivalent and a minimum of 2 years of experience in a multi-specialty physician billing or equivalent medical billing experience

  • Previous physician billing and or credit management experience is preferred

  • Thorough understanding of insurance billing regulations and advanced carrier website navigation preferred

  • Epic experience is highly preferred

  • Attention to detail, good organizational skills, ability to meet priorities within set timeframes, and ability to work as part of a team

  • Applies critical and strategic thinking

  • Knowledge of consumer & federal rights and regulations

  • Comprehensive ability and knowledge of electronic claims processing, electronic remittance advice, electronic payment posting, and clearinghouse functions.

  • Thorough knowledge and understanding of benefits and/or coverage as indicated by third party payer requirements

  • Knowledge of insurance authorizations in relation to medical billing

  • Ability to identify problems and issues of varying complexities and to find effective solutions with few guidelines.

  • Ability to train and support other team members

  • Hybrid/Remote if you live in MA, RI, NH or ME

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.Office/Site Location:WestwoodRegular, Temporary, Per Diem:Regular