Job Description
Join Boston Healthcare Partners as our Senior Billing Specialist and drive revenue excellence in our fast-paced healthcare finance division. We're seeking a detail-oriented professional to optimize our billing operations while ensuring HIPAA compliance and financial accuracy. This hybrid role combines strategic process improvement with hands-on claim management, offering growth opportunities in one of Boston's premier healthcare systems.
Our ideal candidate thrives in collaborative environments and possesses deep expertise in complex billing cycles. You'll work directly with clinical teams to resolve billing discrepancies, implement new coding protocols, and contribute to departmental KPIs. We offer competitive benefits, professional development stipends, and a supportive culture that values work-life balance.
Responsibilities
- Manage end-to-end revenue cycle operations including charge entry, claim submission, and payment reconciliation
- Analyze denial patterns to implement process improvements and reduce DSO (Days Sales Outstanding)
- Ensure compliance with CMS, HIPAA, and payer-specific billing regulations
- Collaborate with clinical teams to resolve coding discrepancies and documentation gaps
- Develop and maintain billing policies/procedures aligned with industry best practices
- Generate monthly financial reports for executive leadership and department heads
- Mentor junior billing staff on complex coding and compliance requirements
Qualifications
- 5+ years of medical billing experience with 3+ years in a leadership/specialist role
- Certified Professional Biller (CPB) or Certified Coding Specialist (CCS) credentials required
- Expertise in CPT, ICD-10, and HCPCS coding with current knowledge of CMS guidelines
- Advanced proficiency in Epic or similar EHR systems and billing software (e.g., NextGen, Medisoft)
- Strong analytical skills with ability to interpret complex financial data and trends
- Proven track record of reducing claim denials by 25%+ in previous roles
- Exceptional communication skills for stakeholder collaboration across departments