Senior Associate, Physician Billing (hybrid)

• Reviews and verifies all demographic and insurance information utilizing available technologies, payer websites, or by phone contact with third party payers or guarantors.
• Collaborates with management and peers to ensure all required information is obtained for resolution of charge edits, claim edits, denials, and appeals in a timely manner, while adhering to government/payer regulation and department policy/procedures.
• Prepares and submits accurate insurance claims and appeals to payer within required timeframes and in accordance with government/payer regulations and requirements.
• Resolves outstanding charges and claims responding timely and accurately for resolution of outstanding balance while adhering to department policies/procedures.
• Accepts, rejects, and reconciles claim runs on timely basis and processes payer response reports in an effective and timely manner.
• Reviews and processes guarantor overpayments per department policies and procedures.
• Responds to inquiries received via telephone and other correspondence from patients/guarantors, insurance carriers, departments/foundations as needed.
• Assist with the training of newly hired staff in process and system navigation

• High School / GED

• Ability to perform at a high level of reliability in all duties.
• Attention to detail, good organizational skills, ability to meet priorities within set timeframes, and ability to work as part of a team.
• Applies critical and strategic thinking.
• Knowledge of consumer & federal rights and regulations.
• Comprehensive ability and knowledge of electronic claims processing, electronic remittance advice, electronic payment posting, and clearinghouse functions.
• Thorough knowledge and understanding of benefits and/or coverage as indicated by third party payer requirements.
• Knowledge of insurance authorizations in relation to medical billing.
• Ability to identify problems and issues of varying complexities and to find effective solutions with few guidelines.
• Ability to take initiative to complete moderately complex assignments.
• Demonstrates professional integrity.
• Ability to train and support other team members

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.