BILLING AND OPERATIONS COORDINATOR / 40 HOURS / DAY / BWH TRAUMA AND BURN
GENERAL SUMMARY/ OVERVIEW STATEMENT:
This person acts as the key facilitator in the revenue cycle management for the Division of Trauma, Burn, and Surgical Critical Care. This position focuses on working through division denials and is fluent in billing-related issues. This position also supports the Trauma and Burn Program Managers within the Division. The ideal coordinator is a highly motivated individual who shows initiative, is goal-oriented with strong problem solving and multi-tasking skills, and has the ability to work as part of a team.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
* Provide consultation to patients regarding insurance coverage. Work with patients and insurance companies to verify eligibility. Check that referrals and/or authorizations are in place when required by insurance company, if not, help patient get referral and/or authorization.
* Develop and maintain adequate, current knowledge of various insurance requirements (medical necessity, eligibility, referral, authorization, pre-certification, etc) and policies for both office visits and surgical procedures, respond to insurance calls regarding any of the above.
* Responsible for overall patient account management. Utilize Epic to the fullest capability. Assist in resolution of edits in electronic charge capture as well as claim edits in Epic.
* Serve as a resource to administrative staff as well as faculty in regards to managed care issues.
* Review all denied insurance claims and provide Billing Agent with information needed to submit an appeal. This requires working with the practice staff, PCPs, and patients to obtain updated information (registration and/or insurance), referrals, etc. Serve as a primary billing contact for problems/issues of rejected claims, as identified by Billing Agent.
* Assists in new staff training regarding the revenue cycle operation.
* Complete all division requirements for billing procedures and follow up (i.e. Epic scheduling, referrals, eligibility checks, denial follow up, etc.), which may include informing physicians of claim issues.
* Attend individual meetings with physicians and Billing Agent to review individual practice activity.
* For Trauma and Burn Program Managers: maintain calendars, initiate scheduling of meetings as required, and facilitate meeting arrangements such as travel, accommodations, materials, etc.
* Answer, screen, and triage incoming calls from patients, referring providers, and BWH colleagues, providing information when appropriate and relaying questions to the faculty and program team when required.
* Complete check requests and reimbursement requests.
* All other duties as assigned by Administrative Director and Trauma and Burn Program Managers.
* Bachelors degree strongly preferred
* Minimum of three years of administrative support experience required. Experience in healthcare billing or managed care also required.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
* Knowledge of healthcare insurance industry rules and regulations.
* Excellent problem solving skills, individually and as part of a team.
* Exceptional organizational skills and attention to detail.
* Very strong computer skills, including word processing, email, calendars, spreadsheets, slide presentations, web-based applications, and internet searches.
* Excellent interpersonal and customer service skills, by phone, by email, and in person.
* Strong command of English language and grammar, and the ability to communicate clearly in English in writing, by phone, and face-to-face.
* Appropriate tone and vocabulary for speaking with patients and surgeons about medical and health issues related to trauma and emergency surgery, burn care, and surgical critical care.
* Ability to prioritize and follow through on a large number of tasks ranging from immediate to long-term and from independent to collaborative.
* Willingness to learn from others and to share ones own knowledge with others.
* Flexibility to assume new responsibilities and to cover others responsibilities when needed.
* Empathy and compassion for patients and their families, colleagues, and care providers.
* Professional demeanor and strong ethical compass, strict attention to patient privacy and confidentiality.
Brigham and Womens Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, ancestry, age, veteran status, disability unrelated to job requirements, genetic information, military service, or other protected status.
BRIGHAM AND WOMENS HOSPITAL I CARE STANDARDS
The I CARE STANDARDS guide me in my interactions with patients, family members, visitors, colleagues, and neighbors in my workplace and surrounding community to optimize the Brigham experience and help fulfill my role in our mission of providing seamless, high quality patient and family centered care.
C. I WILL COMMUNICATE MY COMMITMENT TO HIGH QUALITY PERFORMANCE
A. I WILL APPEAR AND ACT AS A PROFESSIONAL
R. I WILL RESPECT ALL INDIVIDUALS
E. I WILL EXTEND MYSELF