Sr. Physician Billing associate

Boston Children's Hospital; Westwood (MA); On-site; USD 58,000 - 85,000; Full time

Benefits offered by this job

Flexible schedules

Health insurance

Pension

Job summary

Boston Children\'s Hospital is seeking a Senior Physician Billing Associate to ensure timely, accurate submission of physician bills and follow-up on claims. You will resolve denials and appeals, verify demographics and insurance, and collaborate with payer teams to resolve charge edits.

With Epic experience preferred, you will train new staff, manage multiple priorities, and maintain high accuracy in a fast-paced, patient-centered environment that values diversity and teamwork.

Qualifications

• Minimum 2 years of physician billing or equivalent medical billing experience.
• Strong knowledge of insurance benefits and payer processes.
• Experience with electronic claims processing, remittance advice, and payment posting.
• Knowledge of medical billing-related authorizations.

Responsibilities

• Review patient demographics and insurance information for accuracy using payer websites and communications.
• Collaborate with management to resolve charge edits, denials, and appeals.
• Prepare and submit accurate insurance claims and appeals within required timeframes.
• Follow up on outstanding charges and claims to ensure resolution.
• Process guarantor overpayments per policies and procedures.
• Respond to inquiries from patients, guarantors, carriers, and departments by phone or other means.
• Assist with training newly hired staff on processes and system navigation.
• Identify billing issues and work toward timely resolutions.
• Maintain high accuracy while managing daily assignments and priorities.

Skills

Medical billing

Insurance & payer processes

Electronic claims processing

Attention to detail

Education

High School Diploma or GED

Tools

Epic

Clearinghouse experience

Job description

At Boston Children's Hospital, the quality of our care and our inclusive hospital working environment lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures while opening doors of opportunity for our team. Here, different talents, pursue common goals. Voices are heard and ideas are shared. Join us and discover how your unique contribution can change lives. Yours included.

Position Summary

The Senior Physician Billing Associate is responsible for the timely and accurate submission, follow-up, and resolution of physician billing charges and claims. With limited supervision, this position reviews and resolves billing issues, claim edits, denials, appeals, and outstanding balances while ensuring compliance with government and payer regulations and department policies. Epic experience is strongly preferred.

Key Responsibilities

• Review and verify patient demographic and insurance information using available technology, payer websites, and communication with third-party payers or guarantors.

• Collaborate with management and team members to obtain information needed to resolve charge edits, claim edits, denials, and appeals.

• Prepare and submit accurate insurance claims and appeals within required payer and regulatory timeframes.

• Follow up on and resolve outstanding charges and claims.

• Accept, reject, and reconcile claim runs and process payer response reports.

• Review and process guarantor overpayments according to department policies and procedures.

• Respond to inquiries from patients, guarantors, insurance carriers, departments, and foundations by phone and other forms of communication.

• Assist with training newly hired staff on processes and system navigation.

• Identify billing issues and work toward timely and accurate resolution.

• Maintain a high level of accuracy while managing daily assignments and priorities.

Minimum Qualifications

Education:

• High School Diploma or GED required.

Experience:

• 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, electronic remittance advice, electronic payment posting, and clearinghouse functions.

• Knowledge of insurance authorizations related to medical billing.

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

• Ability to work independently while also collaborating effectively as part of a team.

• Ability to manage multiple priorities and meet established deadlines.

• Ability to train and support other team members.

Schedule:

Boston Children\'s Hospital offers competitive compensation and unmatched benefits including 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 and discounted rates on T-passes. Experience the benefits of passion and teamwork.

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 and discounted rates on T-passes. Experience the benefits of passion and teamwork.