Financial Coordinator -BIDMC (Heart Transplant Program)

Job Description

• Establishes and maintains effective policies and procedures for managed care referrals, authorizations, revenue cycle, and co-payment collection.
• Works collaboratively with physicians, patients, and staff to coordinate and process all managed care-related work in compliance with contractual rules and arrangements for multiple managed care organizations. Serves as the primary resource on all departmentally managed care matters.
• Develops, implements and monitors departmental referral and authorization management work and reports findings on a regular basis. Attends all relevant meetings on these topics, insurance meetings and other as a representative of the Department as requested.
• Maintains database of current referral and authorization plan rules and regulations for all managed care plans. Assures the distribution and training of same. Participates in administrative meetings and provides feedback to all staff who participate in workflow related to front-end/referral/managed care.
• Attends Committee meetings. Disseminates information from committee meetings to staff, as appropriate. Implements actions related to the committee work, including preparation and presentation of reports.
• Educates and trains administrative assistants and practice assistants in the areas of referral management, pre-registration and scheduling. Coordinates the training of new administrative staff in the department and provides on-going training as needed.
• Compiles monthly reports and submits to billing companies for reconciliation. Oversees non-billed charges with physician and administrative staff for to ensure that all charges are billed. Processes the edit in the work file and review division work files on a weekly and/or monthly basis.
• Prints and reviews reports and contacts staff regarding late data entry. Manages encounter form volumes and orders in a timely manner. Works collaboratively to update encounter form and manage paper workflow. Prepares reports and statistics for physician meetings as instructed manager.
• Captures and processes TES/Medicode edits for compliance with IDX work files. Submits request forms to update VTE, 'eTicket' fees and edits, including completed provider applications for Out of State Medicaid. Prints and monitors physicians' unsigned notes and reports findings to manager. Prints and monitors the inpatient census report. Reconciles billing data.

Required Qualifications

• A high school diploma or GED is required.
• Three to five years of related work experience is required.
• Experience with computer systems is required, including web-based applications and some Microsoft Office applications such as Outlook, Word, Excel, PowerPoint, or Access.

Competencies

• Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.
• Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
• Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.
• Written Communications: Ability to communicate clearly and effectively in written English with internal and external customers.
• Oral Communications: Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.
• Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.
• Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.

Pay Range

$30.45 – $40.98