Finance Coordinator Job at Massachusetts General Hospital(MGH)
Financial Coordinator
- (3244992)
GENERAL SUMMARY/ OVERVIEW STATEMENT:
This Central Authorization Unit Coordinator is a non-clinical staff member of the Centralized Authorization Unit. This individual is part of an integrated care team that focuses on coordinating the financial aspect to patient care. The coordinator will work with patients and their families, beginning with an initial evaluation of insurance eligibility, coverage for treatment plan, financial liabilities, and prescription benefit coverage. The CAU Coordinator will assist patients throughout their care in their dedicated disease specialty area. Primary responsibilities include verification of insurance benefit eligibility, insurance pre-certification and authorization, verification of prescription benefits, analysis of insurance rejections, and writing payer appeals. This position works with the Centralized Authorization Unit, the Centralized Infusion Unit, and the care team to identify and eliminate barriers to access, reimbursement and affordable care.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
The responsibilities of the Central Authorization Unit Coordinator (Renal Associates) include and are not limited to the following:
- Obtains detailed insurance benefit information and authorizations for all aspects of dialysis treatment care plan
- Completes administrative functions associated with all prior authorization requirements for dialysis, clinic administered medications and retail / take home medications.
- Interviews all dialysis patients and serves as a resource to review insurance, government-program requirements (specifically Medicare enrollment and COB periods), and other financial options. Serves as a financial counseling resource for self-pay patients, assesses financial arrangements, and consults with potential fund-raising sources and grant programs. Works with patients, their families, and transplant team members to help address insurance coverage gaps via alternative funding options.
- Performs financial assessments to determine eligibility for MassHealth, Health Safety Net, Medicare D and all other state-sponsored and federal programs, as well as private insurances
- Computes liability estimates based on gaps in coverage
- Completes administrative functions associated with all prior authorization requirements
- Works with department clinical liaisons for drug grants and programs for inadequately insured patients
- Receives denial and appeal requests and coordinates applicable information and formalizes payer appeals with departmental clinical liaisons
- Manages necessary insurance product needs, including Medicaid and other program enrollment
- Acts as a key contact to physicians, nurses, care team and patients for insurance questions and all aspects of access to care
- Collaborates with International Office where applicable
- Attends appropriate department and practice meetings
SKILLS/ ABILITIES/COMPETENCIES REQUIRED:
- Must be able to provide excellent customer service
- Ability to communicate effectively and sensitively with patients, their families, and hospital staff
- Must possess excellent organizational and prioritizing skills with the ability to multitask
- Ability to problem solve, work under pressure and under very tight deadlines
- Energetic team player with strong communication and interpersonal skills, positive attitude
- Must have adequate typing skills and be familiar with personal computers
- Bilingual in English and another language a plus
EDUCATION:
- Bachelor’s degree, health related field (science, social work, e.g) preferred
EXPERIENCE:
- Excellent Customer Service Skills
- 5-7 years work in healthcare environment (preferred)
- Adequate computer, phone and typing skills
- Microsoft Word and Excel (preferred)
- Strong communication, interpersonal, team skills
- Knowledge of third party payers, government programs, insurance regulations, managed care contracting, medical terminology, and clinical considerations related to cancer care
- Knowledge of medical terminology and coding a plus
- Willingness to continually learn and grow as a member of a team and department
The right candidate is trustworthy, has a positive attitude, quick mind, and thrives while working under strict time-lines. We are looking for a fast learner of public third party payer regulations to ensure reimbursement so that MGH can continue to provide the highest quality of care in the industry for some of our most vulnerable citizens. We will gladly train the right candidate.
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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