Bay Cove Human Services' mission is to partner with people to overcome challenges and realize personal potential. Bay Cove pursues this mission by providing individualized and compassionate services to people facing the challenges associated with developmental disabilities, mental illness, substance use disorders, and homelessness at more than 175 program sites throughout Greater Boston and Southeastern Massachusetts.
Bay Cove Human Services is committed to ensuring the representation and participation of candidates from diverse backgrounds and experiences. We encourage all qualified individuals, particularly those from historically marginalized groups, to apply.
Job Summary:
The Patient Access Coordinator collaborates across services, departments, and payers to ensure timely and accurate registration, demographics, authorization and payment for services provided by Bay Cove. This role is responsible for the administrative and financial-clearance duties necessary to serve our community and accurately collect information needed for accurate billing, collections, or enrolling patients into financial assistance programs. The Patient Access Coordinator contributes to Bay Cove's through providing exemplary service to our clients, accurately collecting needed information, and following processes established by the organization. This position is onsite in Hyannis, MA on Cape Cod and does not have the ability to be remote.
This is a non-exempt position.
Essential Functions of the Position:
Work effectively with colleagues to obtain demographic, insurance, and other needed information to validate eligibility, obtain authorizations, financially clear patients, and resolve missing or inaccurate information in the electronic health record.
Provide professional and courteous customer service at all times and adhere to regulations around confidentiality while serving as the liaison between Behavioral Health Integration services, the billing department, third-party payers, and vendors.
Accurately enter data into required electronic systems (Virtual Gateway EIM/ESM, Electronic Record, third party payer system) in accordance with established timelines.
Conduct ongoing daily verification of client/patient insurance and review authorizations in order to avoid loss of coverage or lapse in authorization, with the goal of maintaining accuracy of patient and financial records.
Research and resolve any errors, denials, exceptions, exclusions and write-offs within 24 hours, resubmit corrected claims, and maintain meticulous records of follow up activities.
Respond to records requests and inquiries from insurance companies, patients/clients, and collateral providers in accordance with Bay Cove's Privacy Policy and regulatory guidance.
Identify patterns of billing errors, inaccurate payments, posting errors, and communicate any needed system changes to direct supervisor.
Complete all required training related to responsibilities and flexibly adjust to changes in billing procedures, practices, and requirements.
Leads training and coaching exercises with employees to continuously improve skill sets
Evaluates procedures and suggest improvements to engage customer service and operational efficiency
Provides ideas and suggestions for process improvements within the departments. Monitors registration and scheduling including insurance verification, to ensure processing within prescribed quality standards
Acts as a training resource for new staff and a resource for coworkers, sharing process and workflow information
Performs other job-related duties as assigned.
Job Requirements:
High school diploma or equivalent required.
Required minimum of 2 years experience of behavioral health billing or similar or any equivalent combination of experience, training and/or education.
Intermediate knowledge of A/R systems, computerized billing, electronic data systems, and electronic health records.
Ability to interact with providers, colleagues, customers, patients/clients, and visitors with skill in detecting and interpreting information, needs, and issues quickly and accurately, occasionally during complex pressured situations.
Demonstrated knowledge of insurance, eligibility, and benefits via Medicaid, Managed Care Medicaid, and Third party payers, including ICD-10 codes.
Must have experience with patient collections for 3rd party insurances (Tufts, Blue Cross Blue Shield, Cigna, Optum Commercial, etc).
Must also have experience serving self-pay patients, and strong understanding of procedures for collecting patient responsibility amounts at time of service.
Must be able to be an educational resource to the rest of the team related to patient access/billing knowledge.
Must be a Certified Revenue Cycle Representative (CRCR) or be willing to take and pass the exam within the first 6 months probationary period of employment.
Comfortable with discussions related to patient payment plans or financial assistance/sliding fee scale determinations
Demonstrated communication, interpersonal, and organizational skills including the capacity to communicate accurate information, instructions, and ideas so others will understand.
Demonstrated ability to maintain confidentiality, exercise sound judgment, and remain calm under pressure.
Intermediate proficiency in word processing and other computer functions using Windows, Word, and Google Email and Apps.
Demonstrated proficiency with utilizing computers and related software (i.e. Microsoft Office, Google, internet applications etc.)
Bay Cove Human Services does not offer visa sponsorships at this time and will require candidates to be authorized to work in the United States.
