Boston Scientific Customer Billing II 

United States, Texas, Houston 

388850740

Your responsibilities will include:

• Maintaining assignment of accounts receivable for area of expertise. This includes following up on accounts through the revenue cycle department, from charge review, claim edits, claim submission, and follow up with third party payers and patients to facilitate prompt resolution of outstanding account balances.
• Interpret EOB including allowed amounts, discounts, in/out-of-network benefit levels, deductibles, co-insurances and copays.
• Apply ICD 10 and CPT code knowledge when reviewing accounts for collections.
• Follow-up on aging accounts receivable insurance claims and appeals.
• Resolve claim edits via work queues and/or our external billing software.
• Compile and file all information needed to appeal denials.
• Follow federal and state regulations to ensure compliance standards are met.
• Monitor timely filing requirements on claims and appeals.
• Evaluate third party payments to ensure accuracy relative to contract language (underpayment/overpayment).
• Accurately document all actions taken to reconcile outstanding balances.
• Communicate with Revenue Cycle teams, payors and others to resolve account problems.
• Participate in meetings as needed to address any potential payor concerns.
• Review and validate adjustments to accounts in the queue based on insurance reimbursement, coverage, contracts and services provided.
• Complete work on special projects, queries and reports as assigned.
• Answer calls regarding insurance claims and patient benefits.
• Meet defined department goals and activity metrics.
• Support co-workers and engage in positive interactions.
• Communicate professionally and timely with internal and external customers.
• Provide helpful assistance in anticipating and responding to the needs of our clients.
• Collaborate with customers in planning and decision making to result in optimal solutions.
• Ability to stay calm under pressure and deal effectively with difficult people.

Required qualifications:

• High School Diploma or equivalent combination of education/work experience.
• Sitting for extended periods of time will be required.
• Use of hands repetitively to type, handle, and operate standard office equipment will be required.

Preferred qualifications:

• Three years of experience in a healthcare revenue cycle, specific to area of
• Expertise.
• Xifin Billing System Experience.
• Knowledge of claims processing and adjustments.
• Knowledge of Medicare, Medicaid, and Commercial carriers.
• Excellent communication and organizational skills.
• Ability to calculate insurance benefits and write appeal letters (using templates).
• Ability to read and understand Explanation of Benefits.
• Insurance verification and basic benefit coordination.
• Knowledge of Medicaid or Medicare Claim Processing regulations.
• Proficient on Microsoft Word, Excel, Outlook, Internet Explorer.
• Ability to work in a collaborative, team environment.
• Ability to work independently and be result driven oriented.
• Ability to be well organized, detail-oriented, in a fast-paced environment.
• Ability to think critically and identify the global impact across the revenue cycle with a solution-oriented approach.
• Maintain confidentiality of sensitive PHI information.

Compensation fornon-exempt (hourly), non-sales rolesmay also include variable compensation from time to time (e.g., any overtime and shift differential) and annual bonus target (subject to plan eligibility and other requirements).

Compensation forexempt, non-sales rolesmay also include variable compensation, i.e., annual bonus target and long-term incentives (subject to plan eligibility and other requirements).

For MA positions:It is unlawful to require or administer a lie detector test for employment. Violators are subject to criminal penalties and civil liability.

Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status. Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment. Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements. As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company’s policies or protocols change with regard to COVID-19 vaccination.