Patient Serv. Coord. III
Massachusetts General Hospital(MGH)


Job Info


GENERAL SUMMARY/ OVERVIEW STATEMENT:

Under the general direction of the Practice Administrator or the Billing and Compliance Manager, the Sr. Billing Specialist is responsible for ensuring the accuracy of all billing documents so that accounts are properly processed, tracking referrals/authorizations, responding to both verbal and written inquires regarding patient accounts, and on occasion collecting payments.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • Receives patient demographic data and encounter forms, reviews documents for accuracy, and secures any missing or inaccurate information (i.e. dates, diagnoses, procedures, third party payer identification numbers, etc.).
  • Reconciles encounter forms to PMIS daily schedule. Maintains files of various documents (correspondence invoices, encounter forms, consents) for own information as well as for that of the other members of the unit. Obtains and provides supportive documentation and /or data for all patient accounts as required. Responsible for tracking all insurance referrals and authorizations.
  • Assists patients in understanding when insurance does not cover certain procedures and arranges for patient payment. Also, reconciles co-payments to patient schedule/receipts.
  • Understands managed care plans, HMOs and unusual coverages and provides information to patients regarding eligibility for procedures. Assists in the orientation and training of new support staff members with regard to billing.
  • Will aid in creating reports and tracing statistics for Service.
  • May respond to written, telephone and personal inquiries from various sources, including current and former patients, MGPO, insurance agencies, etc. regarding problems with bills. Utilizes knowledge of third party payer regulations and PMIS/EPIC CADENCE computer systems in doing so.
  • May provide back up for other Sr. Billing Specialists in Service when necessary.
  • May perform other related duties as necessary.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
  • Demonstrated experience to interface with various levels of the practice, especially with the knowledge and issues related to manage care.
  • Thorough knowledge of EPIC CADENCE system modules and its features, electronic medical record modules and transition to PATCOM, with all system features, as applicable.
  • Demonstrated ability to work independently, with limited supervision, resolve issues, be organized, attentive to detail and achieve outcomes within the team.
  • Demonstrates effective interpersonal and communication skills.
  • Effectively interacts with all levels of management.
  • Demonstrates knowledge of HIPAA Confidentiality and Privacy policies.


Qualifications
Associate's Degree in Secretarial Science/Business, or a Secretarial Training Certificate Program preferred.

Minimum of 3 years work experience in medical group practice, billing and/or managed care setting preferred.

EEO Statement
Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.



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