Billing Specialist

1. Acting as the department/foundation point of contact for various billing areas of BCH (i.e., SSC, SBO, Revenue Integrity, etc.) where department/foundation assistance is needed.
2. Working closely with providers, department leadership, and reporting to keep department/foundation informed of current billing issues/items that are occurring.
3. Managing and resolving all items in department/foundation billing Workqueues.
4. Working closely with Revenue Integrity to manage all charge attestation/missing charges operations.
5. Working with both BCH and billing consultants in chart review for department/foundation providers.
6. Performing complex duties in support of the SSC regarding reimbursement from patients and insurance carriers.
7. Reviewing held claims, determining the reasoning for a bill being held and what the correction is.
8. Analyzing and reviewing claims to ensure that payer-specific billing requirements are met.
9. Meeting and exceeding short and long-term goals and objectives as established for the work unit.
10. Identifying, trending, and communicating effective recommendations for resolution of issues or problems relative to work assignment for department process improvement. Acting as lead for special projects and assignments as identified by management or department on an as-needed basis.
11. Participating in process improvement opportunities. Identifying trends and communicating effectively recommendations for resolution of issues or problems relative to work assignment for department process improvement.

Schedule: Monday-Friday, 8am-5pm, Remote after training * Training will require onsite presence the first couple of weeks, after which the role will be fully remote*

To qualify, you must have:

• High School Diploma
• Minimum 4 years' of experience in a multi-specialty billing or equivalent medical billing experience. Ability to perform reliably and take responsibility for tasks both independently and in a team environment, demonstrating professional integrity.
• Applies critical and strategic thinking to identify and solve problems of varying complexities effectively with minimal guidance.
• Advanced understanding and ability in electronic claims processing, remittance advice, payment posting, clearinghouse functions, benefits, and third-party payer requirements.
• Strives to continuously improve services, processes, and activities affecting quality and productivity.
• Takes initiative in anticipating, preventing, and resolving issues within and outside the department.
• Ability to train and support team members while exemplifying professional integrity.

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.