Patient Accounts Representative

Boston Children’s Hospital; Boston (MA); Hybrid; USD 42,000 - 62,000; Full time

Job summary

Boston Children’s Hospital is seeking a Patient Accounts Representative to deliver strong customer service while managing patient accounts and verifying insurance information. You will submit claims, resolve billing issues, and communicate with patients, families, payers, and hospital staff to support accurate billing and timely resolutions.

Ideal candidates have hospital-based billing experience and knowledge of payer processes.

Qualifications

• High school diploma or GED required.
• Previous medical billing experience preferred.
• Experience with CPT codes and hospital billing practices is a plus.

Responsibilities

• Verify and update patient demographics and insurance information to ensure accurate account processing.
• Confirm insurance eligibility using payer websites and third-party payers.
• Prepare and submit accurate insurance claims within required timeframes.
• Review claims for accuracy, resolve billing errors, and address processing issues with payers.
• Maintain clear account notes documenting actions and collaborate with clinical departments to resolve issues.

Skills

Attention to detail

Analytical thinking

Communication skills

Empathy

Team collaboration

Computer skills

Education

High school diploma or GED

Tools

Automated billing systems

Payer portals

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 escalat...
• 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