Senior Physician Billing Specialist - Claims & Appeals

Boston Children's Hospital; Westwood (MA); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

Flexible schedules

Health insurance

Vision and dental insurance

Child care subsidy

Student loan subsidies

Time off (vacation/sick)

Job summary

Boston Children's Hospital is seeking a Senior Physician Billing Associate to ensure timely submission and follow-up of physician billing charges and claims. With limited supervision, you will resolve denials, edits, and outstanding balances while adhering to regulatory and payer requirements.

Epic experience is highly preferred. You will review demographics, collaborate to resolve issues, process claims and appeals, and train new staff as needed in a hybrid work environment.

Qualifications

• High School Diploma or GED required.
• Minimum of 2 years of experience in multi-specialty physician billing or equivalent medical billing experience.
• Strong knowledge of insurance benefits, coverage requirements, and payer processes.
• Experience with electronic claims processing and remittance posting.
• Knowledge of insurance authorizations related to medical billing.
• Strong attention to detail and ability to manage multiple priorities.

Responsibilities

• Review and verify patient demographic and insurance information.
• Collaborate to resolve charge edits, denials, and appeals.
• Prepare and submit accurate insurance claims and appeals within required timeframes.
• Follow up on and resolve outstanding charges and claims.
• Accept, reject, and reconcile claim runs and payer responses.
• Review and process guarantor overpayments per policies.

Skills

Attention to detail

Organization

Problem solving

Communication

Education

High School Diploma or GED

Tools

Electronic claims processing

Electronic remittance advice

Clearinghouse functions

Job description

Boston Children's Hospital is seeking a Senior Physician Billing Associate to ensure timely submission and follow-up of physician billing charges and claims. With limited supervision, you will resolve denials, edits, and outstanding balances while adhering to regulatory and payer requirements.

Epic experience is highly preferred. You will review demographics, collaborate to resolve issues, process claims and appeals, and train new staff as needed in a hybrid work environment.