At Boston Children's Hospital, the quality of our care - and our inclusive hospital working environment - lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us, and discover how your unique contributions can change lives. Yours included.
Perfect job for new graduates or for those who want to explore a rewarding job in health care. Leadership is willing to develop and train the right candidate. Come join a dynamic team of clinicians and administrators who help Boston Children's Hospital provide the best pediatric care in the country. We support patients, physicians and the hospital revenue cycle by financially clearing all services patients may receive; candidates may be assigned to assist all areas within the financial clearance function as our services evolve and grow over time.
Senior Patient Financial Clearance Representative is responsible for:
Obtaining all insurance authorizations and managed care referrals needed for BCH patients in accordance with insurance companies' medical and administrative policies.
Managing daily caseloads to ensure timely completion of financial clearance in accordance with departmental processes & payer guidelines.
Communicating authorization statuses with key stakeholders (physicians, nurses, management, patients/families) throughout the authorization process.
Support physicians and other clinicians in any payer denial processes, in order to help obtain the proper financial clearance for access to care
Facilitating insurance peer to peer reviews when needed to secure authorizations.
Participating in process improvement activities.
Collecting, verifying, and recording all demographic information required for patient financial clearance in accordance with hospital policy.
To qualify you must have:
The completion of High School Diploma is a min requirement. A Bachelor's degree preferred.
Minimum of 1-year direct experience working with health insurance, referrals and authorizations a plus.
Understanding of Microsoft Office and experience with Epic registration system a plus.
The ability to communicate effectively both orally and in writing
The ability to resolve complex problems requiring the use of critical thinking skills and scientific, mathematical, or technical principles.
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 assignments within established time frames.
Attention to detail and completion of tasks with accuracy.
The ability to work remotely from a home office with a strong internet connection. (Due to HIPAA and patient information, Senior Patient Financial Clearance Representatives are required to work from a private location.)
Please note: During a public health emergency, individuals in this role may be expected to take on additional duties to respond to organizational needs.
Boston Children's Hospital offers competitive compensation and unmatched benefits, including an 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.