Patient Billing Representative

12-month contract with potential for conversion pending budget approval and performance.

About the role

We are seeking a detail-oriented patient billing representative to handle patient inquiries and billing issues in a fast-paced healthcare environment. This position requires excellent communication skills and a strong understanding of billing practices and insurance processes.

Responsibilities

• Respond to a high volume of patient inquiries via phone, mail, and electronic messaging regarding billing and account-related issues.
• Research and resolve patient billing inquiries by collaborating with insurance companies, third-party payers, and other external contacts, and communicate findings to patients and guarantors.
• Collect outstanding balances and update patient demographic and insurance information during interactions.
• Verify insurance eligibility using payer websites, available technologies, and direct communication with insurance companies.
• Understand hospital and professional billing practices, including reading and interpreting Explanation of Benefits (EOBs), billing commercial and government payers, resolving claim denials, and assisting with coordination of benefits (COB).
• Address complex patient and guarantor concerns, including payer denials, coding questions, secondary billing, coordination of benefits, and verification of copays, coinsurance, and deductibles.
• Review Primary Care Provider (PCP) and self-pay exception reports to resolve outstanding issues.
• Identify recurring billing trends or issues and communicate findings to leadership, assisting with process improvement efforts.
• Maintain accurate and complete documentation in accordance with departmental procedures and hospital policies.
• Protect the confidentiality and integrity of patient information by adhering to HIPAA regulations and privacy standards.

Requirements

• High School Diploma.
• 3-5 years of relevant experience.
• 1+ year of experience with EPIC software.
• Experience in a multi-specialty ambulatory clinic.
• Ability to communicate effectively with insurance companies and understand the claims process.

Work Environment

This role offers a hybrid work environment with 1 day per week onsite after the training period, which typically lasts a few weeks. The office is located in Westwood, MA, with free parking available onsite and a shuttle from the MBTA commuter rail station.

Pay

The pay range for this position is $25.00 - $27.00/hr.

Benefits

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital insurance
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)