At Boston Children's Hospital, success is measured in patients treated, parents comforted and teams taught. It's in discoveries made, processes perfected, and technology advanced. In major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As a teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Finance-Government Payors Department and discover how your talents can change lives. Yours included.
This Patient Accounts Representative will be responsible for:
Preparing and submitting accurate insurance claims to payer within proper time frames.
Accepting, rejecting, and reconciling claim runs daily. Ensuring prompt resolution of outstanding insurance claims.
Effectively working payer scrubber and denial reports daily.
Reviewing claims for accuracy and correct errors as needed.
Collaborating with referral/authorization staff to resolve issues.
Resolving claims processing issues with 3rd party payers and provides all requested information timely; engaging patients and family members to resolve claim or insurance issues when needed.
Providing documentation to have claims processed and paid. Researching, preparing, and providing 3rd party payer appeals. Requesting account adjustments in accordance with payer contractual agreements.
Documenting all actions taken on account with clear and concise account notes and maintaining billing logs as required.
Preparing reports as required. Monitoring and identifying trends, denials / claim errors by payer and refer as appropriate.
Maintaining a thorough understanding of 3rd party payer contracts.
Verifying insurance eligibility utilizing available technologies, payer websites, or by phone contact with third party payers.
Ensuring that correct insurance company name, address, plan, and filing order are recorded in the patient accounting system.
To qualify, you must have:
A high school diploma. Previous experience in a medical billing setting, preferably on an automated system is preferred.
The analytical skills to gather and interpret data in situations in which the information or problems are relatively routine.
The ability to exchange information on factual matters. Interaction requires courtesy and tact when dealing with patients, hospital employees and third parties.
The ability to communicate effectively both orally and in writing and provide empathy in difficult interpersonal situations is required.
The ability to work with diverse internal and external constituencies.
Excellent attention to detail, good organizational skills, ability to meet priorities within set time frames, and ability to work as part of a team.
Please note: During a public health emergency, individuals in this role may be expected to take on additional duties to respond to organizational needs.
Boston Children's Hospital offers competitive compensation and unmatched benefits, including affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement and discounted rates on T-passes (50% off). Discover your best.
Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
Internal Number: 3062328
About Boston Children's Hospital
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.