Job Type: Regular

Time Type: Full time

Work Shift: Day (United States of America)

FLSA Status: Non-Exempt

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

The primary functions of the Heart Transplant Financial Coordinator include obtaining insurance authorization for transplant surgery, ensuring that authorizations for all patients on the transplant waiting list are up to date to ensure payment to hospital and surgeons for all transplant surgeries, and processing invoices for donor organs.

The Financial Coordinator will work directly with patients and families during the pre and post-transplant surgery phase. The financial coordinator may also work to support patients on other devices who are not eligible for transplant. As part of a robust multi-disciplinary team, the financial coordinator works closely with nurse coordinators, social workers, doctors and registration staff.

This is a full time opportunity working onsite at Beth Israel Deaconess Medical Center in Boston, MA.

Job Description:

Job Summary: Provides oversight, education and support related to billing, including referrals and authorizations as well as performing other administrative duties.

The following statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities and skills required of this position.

Primary Responsibilities:

Establishes and maintains effective policies and procedures for managed care referrals, authorizations, revenue cycle, and co-payment collection. Ensures that all visits in the department that require a managed care referral or authorization have one obtained or that a waiver is signed. (essential)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 primary resource on all departmental managed care matters. (essential)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 representative of the Department as requested. (essential)Maintains database of current referral and authorization plan rules and regulations for all managed care plans. Assures 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. (essential)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. (essential)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. (essential)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. (essential)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. (essential)Coordinates and prepares of TES/Medicode edits for compliance's 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. (essential)

Required Qualifications:

High School diploma or GED required.3-5 years related work experience required.Experience with computer systems required, including web based applications and some Microsoft Office applications which may include 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.8.Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled