Financial Coordinator

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Obtains insurance authorizations for all elective and emergency appointments and procedures by providing necessary information as required by third party payersin an appropriate time frame.

• Understands notification requirements for date changes and status changes. Requires a complete understanding of coordination of benefits(which includes conducting the Medicare as Secondary Payer Questionnaire (MSP) with Medicare patients) third party payers and managed care plans.

• Informs patient and admitting physician of any potential health insurance authorization concernsprior to appointment/procedure. Coordinates the authorization and approval process in full compliance with payer rules and regulations. Negotiates and orchestrates clinical conversations between MGH physicians and insurance company in order to get a procedure authorized for service. Works with practice staff to postpone and/or reschedule elective procedures if authorization cannot be obtained prior to date of service.

• Confirms verification of benefits from insurers domestic and foreign corporations and other 3rd party payers.

• Develops dental estimates collects deposits payments and initiates transfer of funds to epic or appropriate source.

• Works with management on all billing related process improvement projects.

• Maintains accurate up-to-date records of financial transactions in all relevant systems.

• Prepares dental billing summaries and compiles claims for submission to patient and/or payer.

• Collaborates regularly and positively with the Billing Representative III Practice Manager and the MGPO Billing Managers.

• Conducts follow-up and collection activity with third party payers insurers and/or embassies

• Enters appropriate comments in all billing systems.

• Responds to patient billing and estimate inquiries including requests for itemized bills and summary statement.

• Identifies billing and registration system issues and brings such to managements attention for resolution.

• Works with management to establish departmental billing/insurance policies and procedures as appropriate.

• Brings problematic payers and accounts to the attention of the Practice Manager.

• Acts as a key contact to physicians care team and patients for insurance questions and all aspects of access to care.

• Performs patient registration and admissions functions as needed.

• Attends appropriate department and practice meetings.

Performs other duties or special projects that are Department specific and that are appropriate to this level of position.

SKILLS & COMPETENCIES REQUIRED:

• Excellent verbal and written communications skills

• Effective analytical skills

• Excellent interpersonal skills and ability to develop effective relationships with individuals at all levels in the organization

• Proficiency in medical and dental terminology office automation and hospital wide registration and billing systems

• Proficiency in third party reimbursement billing and collection processes

• Provide outstanding customer service

• Team player works well with others

• Analytically oriented; strong attention to detail

• Ability to work well under pressure and to handle sensitive information and multicultural matters

• Ability to manage a large and varied work load

• Excellent judgment skills with the ability to interface effectively with multinational patients guests and payer sources

• Strong computer skills

• Proactive solution-oriented

• Typing in excess of 40 words per minute

• Familiarity with the MGH environment preferred

EXPERIENCE:

Required:

• Minimum of 3-5 years of relevant experience

Preferred:

• Experience working in a hospital or related health care environment preferred

• Experience with dental billing coding and epic system(s) preferred

At Mass General Brigham our competency framework defines what effective leadership looks like by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance make hiring decisions identify development needs mobilize employees across our system and establish a strong talent pipeline.