Physician Billing Specialist

Position Summary

The Physician Billing Specialist is responsible for making sure physician claims are submitted accurately and on time and that billing issues are followed through to resolution. This role works with patients, insurance companies, and other hospital departments to resolve billing questions, research claim issues, and support the daily billing process. The specialist is also expected to work independently, help train team members, and identify ways to improve billing processes.

Key Responsibilities

• Review and submit physician claims accurately and on time.
• Follow up on outstanding claims and work through billing issues until they are resolved.
• Communicate with patients, insurance companies, and hospital departments to answer billing questions and resolve account issues.
• Research complex billing problems and identify the cause of claim errors or payment issues.
• Review billing trends and recommend ways to improve accuracy, efficiency, and overall processes.
• Meet department goals and manage daily assignments independently.
• Serve as a resource for other team members and help train new and existing staff on billing procedures.
• Participate in special projects and process improvement efforts.
• Provide professional and helpful customer service.

Minimum Qualifications

• Strong knowledge of physician billing and insurance processes.
• Ability to research and resolve complex billing issues independently.
• Strong attention to detail, problem-solving, and organizational skills.
• Ability to work independently and as part of a team.
• Strong communication and customer service skills.
• Ability to train and support other team members.

Education

• High school diploma or GED required.

Experience

• Minimum of 4 years of experience in multi-specialty physician billing or equivalent medical billing experience.
• Advanced knowledge of electronic claims processing, electronic remittance advice, electronic payment posting, and clearinghouse functions.
• Strong understanding of insurance benefits, coverage, and third-party payer requirements.

Schedule

-hybrid

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, employee discounts and discounted commuter benefits at certain locations. Experience the benefits of passion and teamwork.