Job Description

General Summary/Overview Statement:

The Senior Financial Coordinator acts as the key facilitator in the revenue cycle management for the Division of Vascular Surgery. This person is fluent in billing-related issues and assists providers with entering and tracking patient charges. This position also focuses on working through patient claims and denials and is a key resource in billing systems management. The ideal Billing Systems 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 are in place when required by insurance company; if not, help patient get referral.
• 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, including assisting in resolution of claim edits.
• Create and execute a comprehensive Billing/Coding/Reimbursement System to allow for maximum reimbursement and compliance \xe2\x80\x93 working with division staff, Department of Surgery finance staff, etc. Once established monitor all billing/coding/reimbursement processes and correct any issues/variances as they arise.
• 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.
• Assists in new staff training regarding the revenue cycle operation.
• Serve as a primary billing contact for problems/issues of rejected claims, as identified by Billing Agent.
• Schedule all new patient appointments, obtain all necessary documentation and/or authorizations/referrals for initial appointment.
• 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.
• Review and report back to Billing Agent each month regarding:

• write-off requests
• requests for referral of accounts to collection agencies
• all claims that are more than 120 days in A/R
• Report monthly to Division management of practices which have had more than 30 days without response to information requests.
• Obtain all clinic procedure authorizations for all vascular sites.
• Obtain all radiology authorizations for all vascular sites.
• All other duties as assigned by Administrative Director.

Qualifications

Qualifications:

• Minimum of a Bachelor\xe2\x80\x99s degree and/or 3-5 years of billing/administrative experience.
• Knowledge of healthcare billing required.
• Ability and skills necessary to fulfill above requirements.
• Excellent customer service skills required.

Skills/Abilites Competencies Required: * Must maintain highest standards of professionalism, ethics, and integrity.

• Must have strong customer service, communication, and interpersonal skills in dealing with patients, providers, and colleagues.
• Must be team-oriented in dealing with multiple stakeholders and communication channels.
• Must be sensitive to and supportive of patients, families, and care providers.
• Must be resourceful in obtaining information when it is not readily available and in responding to unusual situations.
• Must have ability to recognize problems, establish priorities, and initiate appropriate responses.
• Must be knowledgeable of healthcare billing systems and processes.
• Ability to work independently and use good judgement
• Medical terminology knowledge a must
• Excellent typing skills
• Ability to multi-task

Brigham and Women\'s Hospital