Patient Accounts Representative

Boston Children's Hospital; Boston (MA); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Flexible schedules

Affordable health

Vision and dental insurance

Child care and student loan subsidies

Generous time off

403(b) Retirement Savings plan

Pension

Tuition and License Reimbursement

Cell phone plan discounts

Discounted T-passes

Job summary

Boston Children’s Hospital is seeking a Patient Accounts Representative to support hospital billing operations and patient accounts. The role focuses on verifying insurance information, submitting claims, and resolving billing issues while coordinating with patients, families, payers, and internal teams.

Ideal candidates will have experience with hospital-based billing, payer processes, and knowledge of CPT codes.

Qualifications

• High school diploma or GED required.
• Experience with hospital-based billing and collections preferred.
• Knowledge of CPT codes and medical billing practices.
• Ability to communicate with patients, families, payers, and internal departments.
• Experience with automated billing systems preferred.

Responsibilities

• Verify and update patient demographics and insurance details.
• Confirm insurance eligibility with payer portals.
• Prepare and submit accurate insurance claims.
• Review claims, resolve billing errors with payers.
• Use payer scrubbing and denial reports to resolve claims.
• Research payer appeals and provide documentation.
• Maintain clear account notes of actions taken.
• Collaborate with clinical departments to resolve issues.
• Monitor denials trends and escalate as needed.
• Participate in process improvements.

Skills

Attention to detail

Communication skills

Analytical thinking

Empathy in patient interactions

Team collaboration

Computer proficiency

Education

High school diploma or GED

Tools

Automated billing systems

Payer portals

CRM/account management software

Job description

Position Summary

The Patient Accounts Representative provides positive and effective customer service that supports departmental and hospital operations. This role is responsible for managing patient accounts, verifying insurance information, submitting accurate claims, resolving billing issues, and ensuring timely communication with patients, families, payers, and internal departments. The Patient Accounts Representative works closely with physician offices, service sites, and ancillary departments to support accurate billing and account resolution.

Highly preferred candidates will have experience with hospital-based billing and collections, a strong understanding of payer processes, and knowledge of CPT codes and medical billing practices. Candidates with experience resolving insurance claims, working with payers, and supporting revenue cycle operations are strongly encouraged to apply.

Key Responsibilities

• Verify and update patient demographic, insurance, referral, and authorization information to ensure accurate account processing.
• Confirm insurance eligibility using payer websites, available technology, and communication with third-party payers.
• Prepare and submit accurate insurance claims within required timeframes.
• Review claims for accuracy, resolve billing errors, and address claim processing issues with payers.
• Work payer scrubber and denial reports to identify and resolve outstanding insurance claims.
• Research and prepare payer appeals and provide necessary documentation to support claim payment.
• Maintain clear and accurate account notes documenting all actions taken.
• Collaborate with clinical departments, physician offices, referral/authorization teams, and other internal partners to resolve account issues.
• Monitor trends related to denials, claim errors, and payer issues and elevate concerns as appropriate.
• Maintain a working knowledge of third-party payer contracts and hospital billing processes.
• Participate in process improvement initiatives and departmental projects.

Minimum Qualifications

Education

• High school diploma or GED required.

Experience

• Previous medical billing experience, preferably working with automated billing systems, is preferred

Knowledge, Skills, and Abilities

• Strong attention to detail with excellent organizational skills.
• Ability to analyze and interpret routine account and billing information.
• Strong written and verbal communication skills with the ability to interact professionally with patients, families, hospital employees, and external partners.
• Ability to provide empathy and support when handling difficult patient or billing situations.
• Ability to work effectively with diverse internal and external teams.
• Strong computer skills and ability to accurately enter and retrieve information from automated systems.
• Ability to manage priorities and meet deadlines in a team-oriented environment.

Schedule

Full-time-hybrid /remote

The posted pay range is Boston Children’s reasonable and good-faith expectation for this pay at the time of posting.

Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes

• 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
• discounted rates on T-passes.

Experience the benefits of passion and teamwork.