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.
Peri-Operative Services at SickKids is looking for an Intermediate Financial Analyst, to join the Physician Billing Operations team. Reporting to the Senior Manager, POS Business Operations, and working closely with the Director, Peri-Operative Services, Strategy, Finance & Administration this role supports physician billing, Ministry of Health submissions, physician remuneration, revenue-cycle operations, payment reconciliation, revenue analysis and operational reporting across Peri-Operative Services.
This is a specialized hybrid role combining physician billing operations with billing-related financial analysis and reconciliation. The successful candidate will work with physicians, and physician leadership, Epic analysts, POS administrative and finance teams, as well as Hospital finance, the Ministry of Health and other payers to support accurate registration, charge capture, claims processing, remittance processing, cash posting, account reconciliation and revenue reporting.
Here's What You'll Get To Do
- Manage daily physician billing operations and support weekly and monthly Ministry of Health billing cycles, including claim preparation, submission validation, error review, correction, resubmission and follow-up.
- Review physician billing claims, clinical documentation, registration details, diagnoses, service dates, billing providers and fee codes for completeness, accuracy and compliance with Ontario Ministry of Health and OHIP billing requirements.
- Reconcile inpatient and outpatient billing activity by comparing pending encounters, signed clinical documentation, Epic charge activity, submitted claims, Remittance Advice information and payments received.
- Investigate rejected, errored, unpaid, stale-dated or adjusted claims; prepare Remittance Advice inquiries and follow outstanding items through resolution.
- Complete month-end billing, payment and account reconciliations for surgeons, anesthesiologists, physicians and other faculty supported by Peri-Operative Services.
- Reconcile Remittance Advice payments, cash and payment postings, relativity payments, recoveries, retroactive payments, funding adjustments and other Ministry transactions.
- Maintain monthly accounts, reconciliation schedules, aging reports, payment trackers and supporting working papers, ensuring clear and complete audit trails.
- Perform variance, aging and trend analysis on physician billing, reimbursement, funding and revenue activity to identify discrepancies, collection risks and required follow-up.
- Prepare regular and ad hoc financial and operational reports for physicians, divisional leadership, the Manager and the Director.
- Provide timely analysis and responses to physician and leadership inquiries related to billing, payments, remuneration, errors/denials and outstanding items.
- Support physician onboarding and Ministry affiliation activities, including collection, preparation, validation, submission, tracking and follow-up of required documentation.
- Maintain accurate physician billing information, billing numbers, group affiliations, specialty details, effective dates and related Epic billing configuration requests.
- Work with Patient Registration and operational teams to investigate and correct health-card, insurance, eligibility, demographic, financial-class, provider and encounter issues affecting claims or reimbursement.
- Perform insurance verification and coordinate follow-up with physicians, administrative teams, Service Ontario the Business Office and payers to resolve incomplete or inaccurate information before submission deadlines.
- Work within Epic Resolute Professional Billing and Hospital Billing workflows; previous hands-on experience with Epic Resolute Professional Billing is strongly preferred.
- Review and reconcile Epic charges, claims, denials, adjustments, payments, workqueues and accounts against Ministry remittance information, payer records and operational reports.
- Collaborate with Epic analysts to investigate issues involving charge capture, placeholder charges, coding, billing-provider assignment, routing, claim edits, registration, invoicing, cash posting and reporting.
- Participate in the testing and validation of new fee codes, payer updates, billing edits, workflows, reports, system upgrades and enhancements.
- Review Ministry bulletins and reimbursement changes, assess operational impacts, update procedures and reference materials and support education for physicians and billing staff.
- Conduct claims auditing and identify opportunities to reduce missed charges, duplicate effort, preventable denials, aging accounts and revenue leakage.
- Prepare, review and update professional-fee estimates for International Patient Program cases using treatment plans, expected services, physician involvement, procedure details, anticipated length of stay and applicable pricing methodologies.
- Perform pricing analysis and review patient history and planned services to determine the appropriate consultation, follow-up, procedure, anesthesia, diagnostic and professional-fee components of estimates.
- Analyze international physician-billing revenue and reconcile estimates to final charges, deposits, credit-card receipts, cash postings, adjustments, payments and outstanding balances.
- Collaborate with the International Patient Program, Patient Registration, physicians, clinical teams and Hospital Finance to resolve estimate, registration, insurance, billing and payment discrepancies.
- Support insurance billing, invoicing, reconciliation and payment follow-up for IFHP, Quebec reciprocal billing, UHIP, international insurance, self-pay and other applicable financial classes.
- Investigate payer discrepancies and ensure claims, charges, adjustments, receipts and payment postings are accurately reflected in Epic and operational reporting.
- Use advanced Excel, Excel modelling and, where available, Power BI and SQL or other query languages to analyze billing volumes, payment activity, aging, denials, outstanding claims, funding and revenue trends.
- Develop customized reports, dashboards and presentations that clearly communicate financial and operational results to physicians, managers and departmental leadership.
- Monitor key performance indicators, investigate variances and emerging issues and recommend practical corrective actions.
- Support year-end accounting and audit requirements by preparing reconciliations, schedules, supporting documentation and responses to information requests.
- Maintain and update physician billing manuals, procedures, training materials, fee references and workflow documentation.
- Provide billing guidance and education to physicians, billing staff, POS administrative teams and Epic stakeholders.
- Participate in revenue-cycle management, billing optimization, reporting and continuous-improvement initiatives.
- Support ad hoc requests and special projects as required.
Here's What You'll Need
- Bachelor's degree in Accounting, Finance, Business Administration, Health Administration or a related discipline, or an equivalent combination of education and relevant experience.
- Minimum of 3 years of relevant experience combining physician billing, healthcare reimbursement, financial analysis, accounting, claims processing or revenue-cycle operations.
- Previous experience in an Ontario hospital or academic health sciences centre is strongly preferred.
- Strong knowledge of the Ministry of Health OHIP Schedule of Benefits, physician billing rules, submission cycles, Remittance Advice processes, affiliation requirements, claims correction and stale-dating timelines.
- Experience with physician remuneration and funding models, including AFP, APP fee-for-service, shadow billing, stipends or hospital-based physician compensation, is preferred.
- Experience with Epic Resolute Professional is strongly preferred; experience with Epic Resolute Hospital Billing is an asset.
- Experience with account reconciliation, aging reports, cash and remittance posting, variance analysis, month-end reporting and maintenance of accurate financial records.
- Experience with insurance billing, insurance verification, international patient estimates, payer follow-up and payment reconciliation is an asset.
- Advanced Microsoft Excel skills, including data analysis and modelling, and strong proficiency with Microsoft Office, particularly Excel and PowerPoint.
- Experience with Power BI and SQL or other query languages is preferred; PeopleSoft Financials, Workday Adaptive Planning, QlikView or similar systems are assets.
- Progress toward a recognized accounting designation, preferably CPA.
- Strong analytical and problem-solving skills, with demonstrated ability to investigate discrepancies and implement corrective actions.
- Highly organized, detail-oriented, proactive and able to manage daily operational priorities, complex cases and tight deadlines.
- Excellent verbal, written and financial communication skills, with the ability to work effectively with physicians, managers, administrative teams, Epic analysts, registration teams, hospital partners, the Ministry and external payers.
- Commitment to collaborative, team-based work, process simplification and continuous improvement.
- Demonstrated commitment to advancing equity, diversity and inclusion.
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.
- This position is eligible to enroll in the Healthcare of Ontario Pension Plan (HOOPP). You can learn more about HOOPP's plan features by reviewing The HOOPP Handbook.
- 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
- Temporary, 18-month contract
- 35 hours per week
- Hybrid working arrangement
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.
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.
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.
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ONE document of 20 pages or less as you cannot upload multiple documents as part of your application.
Every application is reviewed by a human recruiter and all hiring decisions are made by people. In some cases, AI-assisted tools are used to help review applications based on job-related qualifications.
All positions posted on the SickKids Hospital's Careers Site represent current vacancies, unless otherwise posted in the job description.
