- Responsible for the management of patient account and payments. Work in conjunction with International Patient Center (IPC) on patient eligibility, verification and authorization of care for BCH international patients prior to and throughout their patient experience.
- Collaborate with International Patient Center on patient eligibility and verification for BCH international patients prior to and throughout their experience.
- Commercial Payor: Verify insurance coverage and benefits; if not contracted with insurance, initiate Single Case Agreement; identify and communicate out of pocket costs to family, IPC CC and Self-Pay colleagues for collection prior to services.
- Embassy Payor: Scan and document in Epic and follows up for Embassy log for past dates of service.
- Self-Pay Payor: Ensure estimate is provided to and explain Self-Pay policy to family.
- Collaborate with International Patient Center on patient authorization of care for BCH international patients throughout their experience.
- Commercial Payor: contact insurance to obtain prior authorization, documents, authorizes in Epic, and notifies leadership, clinic, colleagues a min of 3 business days for at risk services to determine pay or cancel.
- Embassy Payor: Authorize services in Epic for which we have a valid LOG (dates of service and services covered). Utilizes SharePoint to communicate with IPC the status of services without a valid LOG for a minimum of 5 business days in advance. Notify leadership, clinic, colleagues a min of 3 business days in advance for at risk services to determine proceed, or postpone/cancel +/- pay.
- Self-Pay payor: Collects payments 21 days in advance of services when possible; notify leadership, clinic, and colleagues a minimum of 3 business days for non-payment to cancel.
- Develop cost estimate and or collect patient estimates within required timeframes in accordance with self-pay/embassy/payer regulations and requirements and in compliance with Mass Law Chapter 224.
- Monitor all complex patient accounts to ensure hospital and professional invoices, claims, detail bills, and medical records when appropriate are accurately submitted in a timely manner according to payor requirements.
- Collaborate with peers and ensure all required information is obtained for resolution of estimate edits, invoice edits, services denials, and appeals in a timely manner.
- An Associate's degree and 2 years experience working in finance related role or customer service role within a health care setting is required. A Bachelor's degree in Accounting, Business or related field is preferred.
- Knowledge of principles and processes for providing exceptional customer/patient services
- In depth knowledge on various payor types and understands how to investigate and resolve full revenue cycle issues within EPIC
- Ability to Identifies and resolves variances in data trends and analyzes the data used to prepare the financial report
- Hybrid/Remote available
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Int'l Financial Coordinator - Boston, United States - Boston Children's Hospital
Description
Job Posting DescriptionThis position is an integral role in supporting our International patient population and families as well as working closely with our Global Services Department and BCH clinical departments that serve this unique patient population from prior to patient arrival, during patient care while at BCH, and post repatriation back home.
This International Finance Coordinator will be responsible to:
