BWPO BILLING MANAGED CARE COORDINATOR / 40 HOURS / DAY / BWH- OB/GYN
Location: Boston Massachusetts
Description: Brigham and Women's Hospital (BWH) is in need of BWPO BILLING MANAGED CARE COORDINATOR / 40 HOURS / DAY / BWH- OB/GYN right now, this job will be placed in Massachusetts. For complete informations about this job opportunity please give attention to these descriptions. Responsibilities
GENERAL SUMMARY AND OVERVIEW STATEMENT:
Sup! ervised by the Managed Care Supervisor, the Managed Care Coordinator is responsible for obtaining appropriate insurance authorizations, referrals and payments for all patient visits and procedures as well as collection of patient service coinsurance, deductibles and self pay revenue for the Department of OB/GYN Center for Infertility and Reproductive Surgery. There is a high level of direct or phone patient/physician interface.
PRINCIPAL DUTIES AND RESPONSIBILITIES
1. Responsible for obtaining insurance approval for all related activities for Brigham and Satellite operations, prior to initiation of patient services. Duties include verifying insurance eligibility, benefits and ensuring and/or reviewing referral reports to verify active referrals on file for each patient visit. Completing and (upon physician approval) physician treatment plans in their entirety and accurately to insurance companies in order to obtain financial clearance.
2. Responsi! ble for identifying and collecting payments for non covered pa! tient service revenue which includes but is not limited to past due balances, non-covered services; deductibles and coinsurance. Also responsible for correct and accurate posting in the billing system of collected patient service revenue.
3. Explaining insurance coverage to patients, advising patients and staff of patients who do not have approval to start medications, obtaining written pre-certification when necessary, verifying cycle starts as required, pull charts, scan records and communicating and acting as liaison to BWPO Billing Office and OBGYN Satellite facilities, as well as Partners’ Patient Accounts and other physician billing offices as necessary. Requires detailed knowledge of insurance requirements and close attention to patient scheduled appointments since each insurance company has different treatment plan requirements.
4. Responsible for ensuring patients have signed self pay waivers and contracts when appropriate, understand the refund! process, the BWH/PO billing model. Also responsible for ensuring signed documents are scanned into the electronic filing system (RMS). Responsible for explaining fee structures to patients for various treatment options and all other special programs.
5. The Managed Care Coordinator is responsible for the daily start list verifications, daily approval list emails to the BWH CIRS team, ART Option emails, scanning authorization requests in the RMS electronic filing system as well as launching scribes in ARTSITE after financial clearance has been obtained.
6. Responsible for handling all patients’ billing problems and inquiries, and working with and triaging to the Partners’ Patient Accounts, BWPO physician billing offices, Satellites and Brigham Surgical Billing Service to resolve problems. Also responsible for working with BWPO OB/GYN Billing Analysts and Billing Vendor in the resolution of unpaid claims.
7. Responsible for ensuring insurance r! eferrals are received for all IVF cycle services which may include work! ing with the patient’s primary care physician or patient to obtain a referral, obtaining referrals using the POS device, educating secretarial staff regarding which services are and are not covered by each insurance plan and which require a referral. Interface with BWPO IDX Billing system is required, as necessary.
8. Receives and expedites all incoming/outgoing telephone calls in a professional and courteous manner. High level of communication required between clinical team, patient and BWPO management.
9. Might be responsible for determining and entering charges into the BWPO physician or BWH Hospital billing system. Also responsible for communicating appropriate information to BWPO as necessary. Might be responsible for registration duties including but not limited to reporting patient’s change in registration to the billing vendor and to BWH registration, as well as editing patient demographic and fiscal information.
10. Performs cross-cov! erage duties, as necessary, for other Coordinators as well as the Managed Care Supervisor.
Requirements
QUALIFICATIONS :
Two year college degree, preferred
Experience in health care setting and extensive knowledge of 3rd party payers and billing requirements, preferred
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
Excellent interpersonal skills
Excellent written and oral communication skills
Accuracy, with attention to detail
Math/Financial experience
Ability to work both independently and as part of a team
Computer skills, including word processing and data entry
Ability to work under pressure, multi-task and meet deadlines
Familiarity with common office equipment
WORKING CONDITIONS :
Pleasant, but active, office environment
FISCAL RESPONSIBILITY:
Responsible for self pay collections
Shift
Day Shift
EEO Statement
An EEO, AA, VEVRAA Employer
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This job starts available on: Sat, 26 Oct 2013 09:52:18 GMT
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