BWPO SR. PATIENT ACCOUNT REPRESENTATIVE / 40 HOURS / DAY / BWH BWPO OBGYN 8/16/2016

Brigham & Women's Hospital(BWH) Brookline, MA

Company
Brigham & Women's Hospital(BWH)
Job Classification
Full Time
Company Ref #
3023176
AJE Ref #
575894469
Location
Brookline, MA
Experience
Mid-Career (2 - 15 years)
Job Type
Regular
Education
Bachelors Degree

JOB DESCRIPTION

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GENERAL SUMMARY/OVERVIEW STATEMENT:

Responsible for daily management of accounts receivable process and follow-up. Daily management of accounts worked in the EPIC PB Resolute system. The Senior Billing Manager will evaluate progress of work, accuracy, and quality is used to help set benchmarks. The Billing Operations Supervisor will evaluate quality of work which includes quantity and quality of accounts worked daily, accuracy of detail and documentation of work done. This includes daily screening and correcting of claims for accuracy.

Review, correction and completion of edit lists weekly as assigned. This requires the employee to be diligent and take the required initiative to ensure the entire account is corrected, not just the invoice (s) on the list to be corrected.

Follow-up on original and pending claims. The employee is expected to call the insurance company, document the findings and gather and send the necessary documentation to process the claims and document in EPIC the standing of the claim.

Resolve claims appeals. Once a claim is denied and a appeal is appropriate, appeals are to be done on timely basis in order to avoid the filing limit. It is expected of the employee to have the knowledge of what can be appealed and what is not. This includes gathering the information necessary to process the appeal accurately including but not limited the review of payer guidelines, payer EOBs, physician documentation, authorization and eligibility verification, working with the coding representative for a prospective charge correction, as well as accessing all systems available to research information to appeal the denial. The employee must have have a clear understanding of the entire appeals process from start to finish and also be able to work effectively with the OB/GYN Billing Operations Supervisor and the OB/GYN Coding representative as well as document in EPIC all activity on the patient invoice.

Effectively work all required EPIC work queues and compile ATBs for the monthly review.

Respond to patient inquiries. Each employee is responsible for handling customer service calls. Employees must demonstrate excellent customer service skills, listening, problem solving, and respond to calls in a professional manner. If unable to resolve, he/she must write up a complaint form when necessary and refer it to the Billing Operations Supervisor. Complete documentation of the call must be documented in the EPIC system.

Ad hoc projects. When required, the employee is required to complete the project within the specified time frame. The employee is responsible to gather and compile information relevant to the project, log the findings and a final documented report for Senior Billing Manager.

Each employee is expected to respect his or her co-workers and Management. Each employee must possess good interpersonal skills and demonstrate team work.

Each employee must possess excellent organizational skills. When asked questions by Management, each employee is expected to have the knowledge and detail or know how to obtain it.

The work area is expected to be neat and clean at all times.

Each employee is expected to adhere to the rules and regulations of the BWPO and the Department of Pediatric New Born Medicine.

Each employee must demonstrate initiative, independence, and a willingness to learn new tasks. They must be able to work with minimal direction.

Each employee must be able to work as a team and collaborate and contribute to solving problems

Special Projects

As requested by the Senior Billing Manager and Billing Operations Supervisor

QUALIFICATIONS:

Bachelors degree preferred, not required

Minimum of three years experience in a professional billing environment required

Thorough knowledge of Physician third party billing and collections required

Thorough knowledge of third party reimbursements required

Proficient knowledge of Microsoft Word and Excel

EPIC and Payer Website knowledge preferred

SKILLS/ABILITIES/COMPETENCIES REQUIRED:

Excellent organizational skills

Ability to function independently and prioritize work

Strong interpersonal skills, service orientation, and teamwork

Excellent telephone and communication skills

Ability to work well under pressure

Ability to handle sensitive confidential information and data

Excellent knowledge of word processing and spreadsheet software

Knowledge of medical terminology preferred

WORKING CONDITIONS:

Pleasant but busy office environment at BWPO Corporate Office, 111 Cypress Street, Brookline, MA



EEO Statement:

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