Sr. Physician Billing Associate- Hybrid

Boston Children’s Hospital; Westwood, Northern (MA, KY); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Boston Children’s Hospital in Westwood, MA seeks a Sr. Physician Billing Associate to ensure timely submission of physician billing charges with a focus on Epic physician billing and cardiology experience.

You will investigate and resolve complex denials and balances while adhering to payer regulations and department procedures. Responsibilities include reviewing patient demographics, submitting claims, following up on balances, handling appeals, and assisting with training new staff.

Qualifications

• High school diploma or GED.
• At least 2 years of experience in multispecialty physician billing or equivalent medical billing experience.

Responsibilities

• Review and verify patient demographic and insurance information.
• Investigate and resolve charge edits, claim edits, denials, and appeals.
• Prepare and submit accurate insurance claims and appeals within required timeframes.
• Follow up on outstanding charges and claims to resolve balances.
• Accept, reject, and reconcile claim runs and process payer response reports.
• Review and process guarantor overpayments according to department policies.
• Respond to billing inquiries from patients, guarantors, insurance carriers, and internal departments.
• Assist with training new staff on processes and system navigation.

Skills

Epic billing

Denials resolution

Patient communication

Education

High school diploma or GED

Tools

Epic

Job description

Position summary

With limited supervision the Sr. Physician Billing Associate is responsible for the timely and accurate submission of physician billing charges and claims, with a strong focus on Epic physician billing and cardiology experience. Investigates and resolves complex billing issues, claim edits, denials, and outstanding balances, including cardiology-related denials. Ensures assigned work is completed accurately and within required timeframes while following payer regulations and department procedures.

Key responsibilities

• Review and verify patient demographic and insurance information using available systems, payer websites, and phone contact.
• Investigate and resolve charge edits, claim edits, denials, and appeals in collaboration with management and team members.
• Prepare and submit accurate insurance claims and appeals within required timeframes.
• Follow up on outstanding charges and claims to resolve balances.
• Accept, reject, and reconcile claim runs and process payer response reports.
• Review and process guarantor overpayments according to department policies.
• Respond to billing inquiries from patients, guarantors, insurance carriers, and internal departments.
• Assist with training new staff on processes and system navigation.

Minimum qualifications

Education: High school diploma or GED.

Experience: At least 2 years of experience in multispecialty physician billing or equivalent medical billing experience.

Schedule: Hybrid. in office once a week: Westwood location