Under the direct supervision of the Administrative Manager, the Financial Coordinator is responsible for proactive management of the billing process, account oversight and supervision of the revenue cycle to identify opportunities to improve revenue cycle performance. This detail and service-oriented individual collaborates and coordinates on finance-related issues with patients, payers, client specialists, client liaisons, Administrative Manager and other finance areas throughout the organization.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Obtains insurance authorizations for all elective and emergency admissions and procedures by providing necessary information as required by third party payers including Admit Worksheet, clinical, PCP referral etc. in 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 concerns prior to admission/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 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 billing summaries and compiles claims for submission to patient and/or payer.
Collaborates regularly and positively with the Revenue Cycle Account Management team 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 management's 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 Administrative Manager.
Acts as a key contact to physicians, nurses, care team and patients for insurance questions and all aspects of access to care.
Compiles financial reports and provides various complex financial, statistical and productivity reports.
Performs data analysis and makes recommendation to Administrative Manager and the faculty.
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.
Qualifications
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 terminology, office automation and hospital wide registration and billing systems required
Proficiency in third party reimbursement, billing and collection processes required
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 required
Proactive, solution-oriented
Typing in excess of 40 words per minute
Familiarity with the MGH environment preferred
EDUCATION:
High School Diploma or GED required. College education preferred.
EXPERIENCE:
Minimum of 3-5 years of relevant experience required.
Experience working in a hospital or related health care environment preferred
Experience with medical billing, coding and epic system(s) preferred
EEO Statement
Massachusetts General Hospital is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
