Location: Brigham and Women's Surgical Associates in Weymouth
Schedule: Part time, 20hrs
GENERAL SUMMARY/ OVERVIEW STATEMENT: Summarize the nature and level of work performed.
Brigham and Women's Hospital is committed to putting every Patient First. Every employee plays a role in providing a positive impact on patients and the care they receive at Brigham and Women's Hospital. Our service will be distinguished by the delivery of high-quality and safe patient care, respect and dignity in all interactions with patients, families and colleagues and by customer service excellence.
All employees are expected to embrace this commitment and demonstrate behavioral competencies in the following areas:
• People: Focus on serving the community through collaboration and respect
• Self Management: Accountability, professionalism and commitment to growth and development
• Organization: A commitment to quality, service and exceptional performance
Meeting these expectations is key to the success of the department and the organization. This role solely supports the Thoracic Surgery Dept
PRINCIPAL DUTIES AND RESPONSIBILITIES: Indicate key areas of responsibility, major job duties, special projects and key objectives for this position. These items should be evaluated throughout the year and included in the written annual evaluation.
Administrative Duties:
Perform duties under moderate supervision with intermediate to advanced proficiency in administrative skills.
Act as a super user for scheduling, registration, and billing systems. Provide training and assistance to others in these areas.
Perform duties under moderate supervision with intermediate to advanced proficiency in administrative skills.
Perform routine and more complex administrative support such as: typing memos and letters, answering telephones, taking and distributing messages and surgical scheduling.
Proficient scheduling of patient appointments, imaging, testing, etc across MGB enterprise as well as South Shore Health System.
Work collaboratively with other Thoracic administrative staff in the practice to provide patients a positive experience.
Assist with training and orienting staff as needed.
Provide cross coverage as needed including other division admins as well as front desk check in coverage.
Assist with special projects as directed.
Follow HIPAA guidelines for the management of patient privacy and confidentiality.
Other duties, as assigned.
Billing duties:
1. Provide consultation to patients regarding insurance coverage. Work with patients and insurance companies to verify eligibility.
2. Check that referrals are in place when required by insurance company; if not, help patient get referral.
3. Obtain all authorizations for thoracic surgical procedures when required by insurance and make sure to keep provider and patient in the loop if there are any delays or challenges with obtaining authorization.
4. Develop and maintain adequate, current knowledge of various insurance requirements (medical necessity, eligibility, referral, authorization, pre-certification, etc) and policies for both office visits and surgical procedures; respond to insurance calls regarding any of the above.
5. Serve as a resource to administrative staff as well as faculty regarding managed care issues.
6. Review all denied insurance claims and provide Billing Agent with information needed to submit an appeal. This requires working with the practice staff, PCPs and patients to obtain updated information (registration and/or insurance), referrals, etc.
7. Serve as a primary billing contact for problems/issues of rejected claims, as identified by Billing Agent.
8. Complete all division requirements for billing procedures and follow up (i.e. Epic scheduling, referrals, eligibility checks, denial follow up, etc.), which may include informing physicians of claim issues.
9. Assists in new staff training regarding the revenue cycle operation.
10. Responsible for overall patient account management. Utilize Epic to the fullest capability. Assist in resolution of edits in electronic charge capture as well as claim edits in Epic.
Qualifications
Qualifications - External
• High school diploma or GED required; post-high school education preferred.
• Minimum one year of applicable work experience required.
• Additional training in office systems preferred.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
Technical skills required:
• Knowledge of practice operations and standards.
• Understanding of procedures including filing, copying, scanning, printing, and faxing.
Phone skills:
• Ability to use phone system (answer and screen calls, put on hold), answer routine questions, and give routine information.
Verbal skills:
• Ability to interpret information as appropriate, answer routine questions in the most professional manner, and communicate in a professional, courteous, clear, and concise manner.
Organization Skills:
• Ability to manage work processes in a neat and orderly way and to sort and alphabetize.
• Ability to manage multiple tasks effectively, follow established protocols, and work within systems.
Writing Skills:
• Ability to correspond and communicate with others clearly and effectively in writing (via e-mail, memo, or interoffice note) and to take complete and accurate messages.
System Skills:
• Ability to type and enter data at an entry level. Entry level understanding of applicable systems.
• Understanding of the appropriate use and importance of related forms.
• Basic understanding and use of medical terminology.
• Basic comprehension of insurance types and referral process.
• Basic comprehension of registration and fiscal information.
• Knowledgeable and compliant with all hospital, State, and Federal requirements (where applicable to job performance), including policy and procedures with The Joint Commission and HIPAA.
WORKING CONDITIONS:
Hospital based ambulatory practice. Normal patient environments where there are some exposures to communicable diseases, unpleasant odors, needle, and blood products.
HOSPITAL WIDE 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 staff.
EEO Statement
BWH 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.
