Sr Physician Billing Associate - hybrid

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

Job summary

Boston Children’s Hospital seeks a Senior Physician Billing Associate to ensure timely and accurate submission, follow-up, and resolution of physician billing charges and claims across departments.

With limited supervision, you will resolve denials, appeals, and outstanding balances, maintain compliance with payer regulations, and support training for new staff while leveraging Epic experience when available.

Qualifications

• Minimum of 2 years of experience in multi-specialty physician billing.
• Strong knowledge of insurance benefits, coverage requirements, and payer processes.
• Experience with electronic claims processing, remittance advice, and payment posting.
• Ability to work independently and as part of a team, with strong attention to detail.

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, denial, 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.

Skills

Attention to detail

Organization

Problem solving

Communication skills

Education

High School Diploma or GED

Tools

Electronic claims processing

Electronic remittance advice

Electronic payment posting

Clearinghouse functions

Job description

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: hybrid