Physician Billing Specialist

Boston Children's Hospital; Westwood (MA); Hybrid; USD 75,000 - 105,000; Full time

Job summary

Boston Children’s Hospital is seeking a Physician Billing Specialist to ensure accurate and timely submission of physician claims. The role involves resolving billing questions with patients, insurers, and hospital departments, researching complex issues, and supporting daily operations.

The specialist may train teammates and participate in process improvement projects to raise efficiency and accuracy. The ideal candidate has at least four years of multi-specialty physician billing experience,

Qualifications

• Minimum 4 years in multi-specialty physician billing or equivalent
• Advanced knowledge of electronic claims processing, ERA, electronic payment posting, and clearinghouse functions
• Strong understanding of insurance benefits, coverage, and third-party payer requirements

Responsibilities

• Review and submit physician claims accurately and on time
• Follow up on outstanding claims until resolved
• Communicate with patients, insurance companies, and hospital departments to answer billing questions
• Research complex billing problems and identify causes of claim errors or payment issues
• Review billing trends and recommend improvements to accuracy and efficiency
• Meet department goals and manage daily assignments independently
• Serve as a resource for team members and train staff on billing procedures
• Participate in special projects and process improvement efforts
• Provide professional and helpful customer service

Skills

Physician billing

Insurance processes

Customer service

Problem solving

Team training

Independent work

Education

High school diploma or GED

Job description

Position Summary

The Physician Billing Specialist is responsible for making sure physician claims are submitted accurately and on time and that billing issues are followed through to resolution. This role works with patients, insurance companies, and other hospital departments to resolve billing questions, research claim issues, and support the daily billing process. The specialist is also expected to work independently, help train team members, and identify ways to improve billing processes.

Key Responsibilities

• Review and submit physician claims accurately and on time.

• Follow up on outstanding claims and work through billing issues until they are resolved.

• Communicate with patients, insurance companies, and hospital departments to answer billing questions and resolve account issues.

• Research complex billing problems and identify the cause of claim errors or payment issues.

• Review billing trends and recommend ways to improve accuracy, efficiency, and overall processes.

• Meet department goals and manage daily assignments independently.

• Serve as a resource for other team members and help train new and existing staff on billing procedures.

• Participate in special projects and process improvement efforts.

• Provide professional and helpful customer service.

Minimum Qualifications

• Strong knowledge of physician billing and insurance processes.

• Ability to research and resolve complex billing issues independently.

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

• Ability to work independently and as part of a team.

• Strong communication and customer service skills.

• Ability to train and support other team members.

Education:

- High school diploma or GED required.

Experience:

• Minimum of 4 years of experience in multi-specialty physician billing or equivalent medical billing experience.

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

• Strong understanding of insurance benefits, coverage, and third-party payer requirements.

Schedule:

hybrid