Sr Patient Finance Rep
Boston Children's HospitalAbout the role
Status
Full-Time
Standard Hours per Week
40
Job Posting Category
Finance
Job Posting Description
Manages daily assignments using standardized protocols and work queues to ensure timely completion of financial clearance in accordance with departmental processes and payer guidelines. Collects, verifies, and records all demographic information required for patient financial clearance in accordance with hospital policy. Verifies insurance eligibility utilizing available technologies, payer websites, or by phone contact with third party payers. Works in accordance with required State and Federal regulations and hospital policies. Ensures that correct insurance company name, address, plan, and filing order are recorded in the patient accounting system. Uses payer exception reports to update coverage / PCP information. Contacts PCP (primary care physician) offices to secure referrals and enter referrals into patient accounting system. Collaborates with clinical departments, case managers and clinical liaison to ensure payer authorizations are obtained timely. Proactively engages patients and family members to determine coverage limitations and financial liability. Communicates with physician offices, service sites and ancillary departments if referrals/authorizations are denied at least 72 hours prior to service date. Facilitates peer to peer reviews when needed to secure authorizations. Documents all actions taken on accounts with clear and concise account notes. Participates in process improvement activities.
Office/Site Location
Boston
Regular, Temporary, Per Diem
Regular
Remote Eligibility
Full-Time Remote
Pay Range
$22.35-$35.76 Hourly
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