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Job Summary
Brigham is a global leader devoted to maintaining and restoring health for people everywhere. Brigham is composed of Brigham and Womens Hospital (BWH) Brigham and Womens Faulkner Hospital (BWFH) and Brigham and Womens Physicians Organization (BWPO).Qualifications
The Financial Coordinator acts as a resource and financial counselor for transplant candidates and their families providing financial guidance in a compassionate and tactful manner in order to help facilitate access and provide continuity of care. The Financial Coordinator works extensively with the transplant team members third party payers government agencies other funding agencies and hospital financial/billing staff. He/she facilitates transplant billing and provides quality service to patients by providing comprehensive and ongoing financial counseling and by identifying and helping to resolve financial coverage issues.
Overall duties
Meets with potential transplant patients to assess financial means and needs and provide financial information and resources as needed. Assists with financial planning.
Obtains detailed patient insurance benefit information and assists with verification of coverage relating to all aspects of the transplant process including but not limited to: evaluation transplantation outpatient prescription drug benefits post-transplant services out-of-pocket maximums and travel and housing if necessary. Determines co-payment expectations and other potential out-of-pocket liability.
Serves as a resource for patients and family members on financial matters throughout the transplant process. Works with patients their families and transplant team members to address insurance coverage gaps and issues and investigates alternative funding options as necessary.
Advises transplant candidates on insurance and funding options including providing information regarding alternate funding and choices of insurance coverage i.e. Medicare and Medicaid eligibility COBRA Social Security Disability retirement plans etc. Provides information to patients regarding available medication assistance programs and assistance with co-payments and organizations that can assist with fund-raising. Assists with applications eligibility guidelines and other necessary paperwork or process issues to access such assistance.
Keeps apprised of changes in federal and state (FDA/HFCA etc.) guidelines and policies related to organ transplantation.
Obtains all necessary payer authorizations verifies transplant coverage and other medical benefits as needed for pre/post-transplant and VAD patients.
Monitors and updates information regarding insurance data authorizations and preferred providers on a regular basis. Follow-ups with patients throughout the transplant process as necessary for financial needs.
Working with hospital staff and division finance/billing staff facilitates resolution of patient billing issues.
Keeps clinical staff informed of all patients financial information and alerts staff to any issues that may impact patients ability to undergo services during the transplantation process.
Serves as a routine resource to the Transplant team and provides explanation to the clinical and administrative staff in regard to transplantation reimbursement criteria and insurance coverage.
Participates in transplant program multi-disciplinary and/or other patient management meetings and is prepared to provide pertinent financial information.
Responsible for managing the charge router and organ acquisition work queues in EPIC.
Participates in patient orientation sessions and/or other patient information forums as required.
Transplant Service Line
Cross coverage to all clinics a week in advance to ensure a referrals and authorizations are on file for pre and post-transplant patients in kidney lung heart and VAD program
Sends out weekly open encounter reports to ensure encounters are closed in a timely manner.
Acts as a billing coordinator to support coding and billing inquiries.
Maintain financial and denial WQs and reports.
Administration
Send out patient financial overview via epic or mail
Documents patient calls and status updates in epic
Monitor the shared outlook mailbox and have a response rate of 24-48 hours to emails
Scan in authorization responses from payers in epic
Upload appropriate documents into epic and or payer websites/portals
Run reports daily or weekly in epic
Join and participates in recurring team meetings
Other
Participates in quality assurance and process improvement projects as appropriate.
Participates in relevant special projects.
Performs other duties as assigned and/or required.
Education
- High School Diploma requires
- Bachelors Degree a plus!
Experience
- 1-2 years of direct experience with healthcare insurance benefits preferably in a hospital setting. Experience with transplant financial issues and/or insurance coverage a strong plus.
- Demonstrated strong experience working effectively with patients doctors and nurses.
- Experience with transplant financial issues and/or insurance coverage a strong plus
Knowledge Skills and Abilities
- Ability to work effectively in a team and multi-disciplinary environment
- Strong attention to detail and organization.
- Must have the ability to work independently follow up on tasks and use judgement.
- Must be a team player and enjoy working with people both on the telephone and in-person; ability to deal effectively with difficult people.
- Excellent interpersonal and communication (oral written e-mail grammar) skills necessary.
- Excellent computer skills; proficient with Microsoft Word Excel PowerPoint.
- Knowledge of the patient access processes (i.e. admitting pre-op registration).
- Medical terminology knowledge a must.
- Ability to work effectively in a team and multi-disciplinary environment.
Licenses and Credentials
No
WORKING CONDITIONS:
- Hybrid Model
SUPERVISORY RESPONSIBILITY:
NA
FISCAL RESPONSIBILITY:
- Support fiscal ending activities (financial WQs)
Additional Job Description:
OTHER DUTIES AND RESPONSIBILITIES
- Works within legal regulatory accreditation and ethical practice standards relevant to the position and as established by BWH/Partners
- Follows safe practices required for the position.
- Complies with appropriate BWH and Partners policies and procedures.
- Fulfills any training required by BWH and/or Partners as appropriate.
- Brings potential matters of non-compliance to the attention of the supervisor or other appropriate hospital.
Additional Job Details (if applicable)
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$19.42 - $27.74/HourlyGrade
3EEO Statement:
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.
Required Experience:
IC
Patients at Mass General have access to a vast network of physicians, nearly all of whom are Harvard Medical School faculty and many of whom are leaders within their fields.