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CENTRAL BUSINESS SERVICES REPRESENTATIVE / 40 HOURS / DAY / BWH - CENTRAL BUSINESS SERVICES 9/18/2017

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

Company
Brigham & Women's Hospital(BWH)
Job Classification
Full Time
Company Ref #
3047418
Location
Brookline, MA
Experience
Entry Level (0 - 2 years)
Job Type
Regular
Education
High School Diploma or GED
AJE Ref #
579553410

JOB DESCRIPTION

APPLY
GENERAL SUMMARY/ OVERVIEW STATEMENT:

Reporting directly to the Central Business Services Supervisor and under the general direction of the Central Business Services Manager, the Central Business Service Representative performs a variety of functions to ensure all payments and adjustments are applied accurately and timely, and all credit balances of self pay and third party credit balances are resolved accurately and in a timely manner. This position is relied upon to work with a team to gain knowledge and expertise in maximizing productivity by posting payments received and applying gained knowledge of payer rules and regulations with regards to coinsurance, deductibles, and co-pays as well as internal policies and procedures. The Central Business Service Representative is to participate as directed in the root cause analysis of credit creation and identify issues and trends.



PRINCIPAL DUTIES AND RESPONSIBILITIES:

* Achieve excellence in performance by working collaboratively with others on BWPO initiatives.

* Supports and demonstrates the values of the BWPO by conducting activities in an ethical manner with integrity, honesty, and confidentiality. Demonstrates a positive, open-minded, can-do attitude. Represents a team perspective and willingness and enthusiasm to collaborate with others. Follows through on commitments and achieves desired results. Exhibits sound judgment, obtains the facts, examines options, gains support, and achieves positive outcomes.

* Maintain high standards of professional conduct at all times.

* Enthusiastically promote a cooperative team environment to provide value to all departments and customers. Act as a leader in creating a positive atmosphere within the team. Listen and interact tactfully, diplomatically and effectively without alienating others.

Cash/Account Management and Credit Resolution

*

Demonstrate competency and a thorough understanding of Epic. Navigate patient accounts utilizing Epic system to effectively resolve credit balances.
*

Apply knowledge of insurance rules and regulations with regards to coinsurance, deductibles, and co-pays for the efficient handling of payments.
*

Meet deadlines as well as quality and productivity standards for EPIC including but not limited to:

1. Manual posting of funds

2. Manual posting of rejections received

3. Accurately interpret insurance EOBs with appropriate rejection codes

4. Reconciliation of EPIC batches posted to deposit total

5. Correspondence & phone inquiries

6. Accurately and timely processing of deposits

* Apply transfers, payments and/or adjustments to invoices as necessary to complete the resolution of each invoice.

* Ensure that all areas that have a direct relationship to cash flow (ie cash posting edit lists) are worked as assigned by Manager.

* Interpret issues through effective review of accounts while posting within EPIC. Assist in the identification of root causes.

* Research and resolve assigned credit balances using a variety of tools and systems including Epic for patient accounting, as well as RMS and Hyland On Base imaging systems for documentation.

* Determine the cause for the credit, making appropriate debit transaction adjustments and refunding the appropriate party. Including but not limited to navigating payer websites to ensure accuracy of coordination of benefits, contacting patient and/or working with central registration team to update insurance.

* Self pay refunds must also be reviewed to insure that there are no outstanding debit balances or bad debt across all BWPO Departments as well as the facilities.

* Responsible for contacting third party payers to resolve any over payment issues and when appropriate request that a retraction be performed.

* Work closely with all BWPO Departments and teams.

* Interpret issues through effective review of accounts while posting within EPIC. Assist in the identification of root causes.

* Maximize all features of EPIC to ensure thorough and accurate postings occur and to trouble shoot issues. Identify and recommend adjustments to workflows as it relates to current AR issues.

* Demonstrate proficiency with a variety of automations, including but not limited to EPIC, Microsoft Word, Excel, E-mail.

* Participate in continuous quality improvement efforts on an ongoing basis. Establish goals with Manager and track progress. Comply with hospital confidentiality policy. Manage special projects as assigned.

* Be an effective team member with good communication and organizational skills. Participate in team meetings, communicate work related ideas and concerns proactively and assist in finding appropriate resolutions.

* Assist in staff training of new and current staff, on the credit resolution process.

* Perform other duties and tasks as assigned

QUALIFICATIONS:

* High School diploma or GED equivalent required

* One to three years experience in medical billing and AR systems required.

* Effective communication, organizational and problem solving skills

* Epic knowledge preferred

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

* Excellent customer service skills

* Excellent computer keyboard skills

* Effective communication and interpersonal skills to successfully interact with internal and external customers

* Effective organizational and problem solving skills

* Ability to manage multiple tasks/projects simultaneously

* Knowledge of medical insurance rules and regulations with regard to patient responsibilities preferred

* Detail oriented

* Adapt positively to changes in the work setting with ease

WORKING CONDITIONS:

* Office environment

* The work environment is very busy and dynamic

* Staff is very collaborative and work together to solve issues with particular practice issues

Brigham and Womens Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, sexual orientation, protected veteran status, or on the basis of disability.