Customer Billing II

Additional Location(s):  N/A

Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance

At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we’ll help you in advancing your skills and career. Here, you’ll be supported in progressing – whatever your ambitions.       

About the role: 
Account Resolution Specialist is a position within our Houston Based Boston Scientific Cardiac Diagnostic revenue cycle team that works with insurance and patients regarding their cardiac diagnostic services claims. This position is responsible for reviewing and collecting denied insurance claims. Additionally, this position assists in problem solving, fact finding and assisting patients through complicated insurance processes. If you love working with people, patient satisfaction and problem solving this is a great opportunity to join the Boston Scientific Corporation team with opportunities to grow your career within a great company. At Boston Scientific, we value collaboration and synergy. This role allows a hybrid work model, requiring employees to be in our local office at least three days per week. Relocation assistance is not available for this position at this time. Boston Scientific will not offer sponsorship or take over sponsorship of an employment VISA for this position at this time.

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. 

Requisition ID: 604408

Minimum Salary: $[[cust_salaryMin]] 

Maximum Salary: $[[cust_salaryMax]] 

The anticipated compensation listed above and the value of core and optional employee benefits offered by Boston Scientific (BSC) – see www.bscbenefitsconnect.com--will vary based on actual location of the position and other pertinent factors considered in determining actual compensation for the role. Compensation will be commensurate with demonstrable level of experience and training, pertinent education including licensure and certifications, among other relevant business or organizational needs. At BSC, it is not typical for an individual to be hired near the bottom or top of the anticipated salary range listed above.

Compensation for non-exempt (hourly), non-sales roles may 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 for exempt, non-sales roles may 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.

As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most – united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate. Now more than ever, we have a responsibility to apply those values to everything we do – as a global business and as a global corporate citizen.

So, choosing a career with Boston Scientific (NYSE: BSX) isn’t just business, it’s personal. And if you’re a natural problem-solver with the imagination, determination, and spirit to make a meaningful difference to people worldwide, we encourage you to apply and look forward to connecting with you!

At Boston Scientific, we recognize that nurturing a diverse and inclusive workplace helps us be more innovative and it is important in our work of advancing science for life and improving patient health. That is why we stand for inclusion, equality, and opportunity for all. By embracing the richness of our unique backgrounds and perspectives, we create a better, more rewarding place for our employees to work and reflect the patients, customers, and communities we serve. 

Boston Scientific Corporation has been and will continue to be an equal opportunity employer. To ensure full implementation of its equal employment policy, the Company will continue to take steps to assure that recruitment, hiring, assignment, promotion, compensation, and all other personnel decisions are made and administered without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identify, gender expression, veteran status, age, mental or physical disability, genetic information or any other protected class.

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.