About SickKids

Dedicated exclusively to children and their families, The Hospital for Sick Children (SickKids) is one of the largest and most respected paediatric healthcare centres in the world. As innovators in child health, we lead and partner to improve the health of children through the integration of healthcare, leading-edge research and education. Our reputation would not have been built - nor could it be maintained - without the skills, knowledge and experience of the extraordinary people who come to work here every day. SickKids is committed to ongoing learning and development, and features a caring and supportive work environment that combines exceptionally high standards of practice.

When you join SickKids, you become part of our community. We share a commitment and determination to fulfill our vision of Healthier Children. A Better World.

Don't miss out on the opportunity to work alongside the world's best in paediatric healthcare.

Position Description

Reporting to the Manager, Business Operation for Peri-Operative Specialties, the Physician Billing Associate will be responsible for coding and inputting surgical and other billing, ensuring accuracy and compliance with Ministry of Health (MOH) guidelines.

Here's What You'll Get To Do:

• Review physician billing claims for completeness and accuracy and prepare for submission to the Ministry of Health adhering to the submission deadlines.
• Reviewing medical documentation to validate claims and assign appropriate billing codes to procedures and diagnoses in compliance with regulatory guidelines.
• Review outstanding billing reports (outpatient, inpatient, surgical) to reconcile pending visits against medical documentation, and contact physicians to follow up, ensuring outstanding claims do not become stale dated.
• Follow up and re-submit errored and denied OHIP claims, prepare Remittance Advice Inquiries and endeavor to maximize revenue due to departments. Track MOH responses and contact MOH to follow up on outstanding responses.
• Provide billing expertise and offer billing solutions/education from inquiring physicians.
• Provide guidance to physicians on billing rules, and general Epic physician workflows.
• Prepare Reciprocal, IFHP, Quebec, International, Insurance and Self-Pay billing claims.
• Participate in departmental meetings, reviewing billing workflows and processes.
• Keep up to date on Schedule of Benefits rules and regulations and MOH Bulletins and adopt changes into practice.
• Provide support to other team members during any absences.
• Partner with the Ministry of Health and other insurance agencies on charges and payments, interpreting fee code schedules as it applies to their specialities to provide advice and recommendations to faculty and Division Heads.
• Conduct regular audits to identify billing errors and implement corrective action.
• Develop working relationships with multiple physicians, Epic analysts as well as clinical operations teams to support registration and billing workflows.
• Run and analyze reports and independently follow up with faculty on findings and follow ups.
• Reconcile EPIC billings with Ministry of Health reports.
• As EPIC evolves, maintain a lens of continuous improvement to enhance billing processes.
• Maintain patient confidentiality and adhere to PIPEDA (Personal Information Protection and Electronic Documets Act) regulations.

Here's What You'll Need:

• Previous physician billing experience, preferably a minimum of five years e (Surgical, Anesthesia, Paediatric or Critical Care preferred), combined with post-secondary education.
• You work well in a team environment and are also able to work independently in a fast-paced environment.
• You will be proficient in Windows Outlook, Microsoft Excel (Advanced Level necessary) and Word.
• You will possess excellent computer and keyboarding skills.
• You will have experience working with/and knowledge of medical billing software (Epic preferred).
• You will have considerable knowledge and an understanding of the rules and application of the MOH OHIP Schedule of Benefits.
• A commitment to understanding and aiding in the pursuit of equity, diversity and inclusion objectives.

In addition, you demonstrate:

• Exceptional organizational, time-management, problem-solving and interpersonal skills. You will be able to prioritize and maximize your time, while working with deadline constraints.
• Possess excellent analytical skills.
• Excellent written and verbal communication skills.
• Ability to handle interruptions and multiple priorities.
• Attention to detail and accuracy.
• Ability to work on diverse tasks with limited direction.
• Commitment to the financial strategic directions of the Department as it pertains to physician billing.

Here's What You'll Love:

• This position is eligible for employee benefits coverage including but not limited to; health, dental and life insurance. The full benefits package will be discussed at the time of offer.
• A focus on employee wellness with our new Staff Health and Well-being Strategy. Self-care helps us support others.
• A hospital that welcomes and focuses on Equity, Diversity, and Inclusion.
• The opportunity to make an impact. Regardless of your role or professional interest, you will be making a difference at SickKids and contributing to our vision of Healthier Children. A Better World.
• For more on why you'll love working at SickKids, visit our careers site.

Employment Type: Full-time Permanent, 1.0 FTE

Our Commitment to Diversity

SickKids is committed to championing equity, diversity and inclusion in all that we do, fostering an intentionally inclusive and culturally safe environment that reflects the diversity of the patients, families and communities we serve. Learn more about workplace inclusion.

Accessibility & Accommodation

If you require accommodation during the application process, please reach out to our aSKHR team. SickKids can provide access and inclusion supports to eligible candidates to support their full engagement during the interview and selection process as well as to ensure candidates are able to perform their duties once successfully hired. If you are invited for an interview and require accommodation, please let us know at the time of your invitation to interview. Information received related to access, inclusion or accommodation will be addressed confidentially.

How To Apply

Technical difficulties? Email ask.hr@sickkids.ca with a short description of the issues you are experiencing. We will not accept resumes sent to this inbox but we are happy to respond to requests for technical assistance.

Tip: Combine your cover letter and resume into ONE document of 20 pages or less as you cannot upload multiple documents as part of your application.