At Boston Children's Hospital, success is measured in patients treated, parents comforted and teams taught. It's in discoveries made, processes perfected, and technology advanced. In major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As a teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Finance- Patient Access and discover how your talents can change lives. Yours included.
The Senior Patient Finance Representative will be responsible for:
Managing daily assignments using standardized protocols and work queues to ensure timely completion of financial clearance in accordance with departmental processes and payer guidelines.
Collecting, verifying, and recording all demographic information required for patient financial clearance in accordance with hospital policy.
Verifying insurance eligibility utilizing available technologies, payer websites, or by phone contact with third party payers. Working in accordance with required State and Federal regulations and hospital policies.
Ensuring that correct insurance company name, address, plan, and filing order are recorded in the patient accounting system.
Using payer exception reports to update coverage / PCP information.
Contacting PCP (primary care physician) offices to secure referrals and enter referrals into patient accounting system.
Collaborating with clinical departments, case managers and clinical liaison to ensure payer authorizations are obtained timely.
Proactively engaging patients and family members to determine coverage limitations and financial liability.
Communicating with physician offices, service sites and ancillary departments if referrals/authorizations are denied at least 72 hours prior to service date.
Facilitating peer to peer reviews when needed to secure authorizations.
Documenting all actions taken on accounts with clear and concise account notes.
Participating in process improvement activities.
To qualify, you must have:
A High School Diploma and a minimum of 1 year of direct experience working with health insurance, referrals and authorizations.
The ability to communicate effectively in English both orally and in writing and provide empathy in difficult interpersonal situations.
The ability to resolve complex problems requiring the use of basic scientific, mathematical, or technical principles is required.
Excellent customer service skills and a good understanding of computer systems are required. Familiarity with basic medical terminology is required.
The ability to work as part of a team with diverse internal and external constituencies.
Effective organizational skills and the ability to work in a fast-paced environment to ensure completion of work within established timeframes.
Excellent attention to detail and completion of tasks with accuracy.
Hospital/Healthcare experience strongly preferred
***Obtaining Authorizations for Genetic testing, Day Surgeries, Admissions and Inpatient visits.***
Boston Children's Hospital offers competitive compensation and unmatched benefits, including affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, cell phone plan discounts and discounted rates on T-passes (50% off). Discover your best.
Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.