At Boston Children's Hospital, success is measured in patients treated, parents comforted and teams taught. It's in discoveries made, processes perfected, and technology advanced. In major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As the teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Shared Service Center and discover how your talents can change lives. Yours included.
This Physician Billing Senior Associate will be responsible for:
Reviewing and verifying all demographic and insurance information utilizing available technologies, payer websites, or by phone contact with third party payers or guarantors.
Collaborating 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.
Preparing and submitting accurate insurance claims and appeals to payer within required timeframes and in accordance with government/payer regulations and requirements.
Resolving outstanding charges and claims responding timely and accurately for resolution of outstanding balance while adhering to department policies/procedures.
Accepting, rejecting, and reconciling claim runs on timely basis and processes payer response reports in an effective and timely manner.
Reviewing and processing guarantor overpayments per department policies and procedures.
Responding to inquiries received via telephone and other correspondence from patients/guarantors, insurance carriers, departments/foundations as needed.
Assisting with the training of newly hired staff in process and system navigation.
To qualify, you must have:
High School diploma or equivalent.
Minimum of 2 years of experience in a multi-specialty physician billing or equivalent medical billing experience.
Ability to perform at a high level of reliability in all duties.
Attention to detail, good organizational skills, ability to meet priorities within set timeframes, and ability to work as part of a team.
The ability to apply 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 take initiative to complete moderately complex assignments.
Demonstrates professional integrity.
Ability to train and support other team members.
Boston Children's Hospital offers competitive compensation and unmatched benefits, including affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, cell phone plan discounts and discounted rates on T-passes (50% off). Discover your best.
Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
Internal Number: 2865327
About Boston Children's Hospital
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.