Senior Financial Coordinator - Transplant - Hybrid at Brigham & Women's Hospital(BWH) in Boston, Massachusetts

Job Description:

Description - External




GENERAL SUMMARY/ OVERVIEW STATEMENT:



Brigham is a global leader, devoted to maintaining and restoring health for people everywhere. Brigham is composed of Brigham and Women's Hospital (BWH), Brigham and Women's Faulkner Hospital (BWFH), and Brigham and Women's Physicians Organization (BWPO).


Brigham is an academic medical center with a firm commitment to its tripartite mission. From the clinical standpoint, Brigham serves patients from New England, throughout the United States, and from 120 countries around the world. These clinical services are supported at 2 hospitals and 150 outpatient practices, by more than 1,200 physicians. From the research standpoint, Brigham conducts the second largest hospital-based research program in the world, with an annual research budget of more than $630 million. And from the education standpoint, Brigham is a training ground for physicians, nurses, and allied health professionals. We have 1,100 trainees in over 140 of the most sought after training programs in the world, and also host Harvard Medical School students in rotations throughout our programs.


Brigham is an internationally recognized leader in transplantation services, providing advanced care for a wide spectrum of organ and tissue transplants, including kidney, pancreas, lung, heart, face, hand, and bone marrow.


Many transplant milestones have taken place here, including the world's first successful human organ transplant, a kidney transplanted in 1954. Since this groundbreaking start, our transplant programs have continued to build upon this innovative spirit, and currently perform ~150 transplants each year.



PRINCIPAL DUTIES AND RESPONSIBILITIES:




Transplant Service Line, Senior Financial Coordinator



As an integral part of the Transplant Service Line, the Senior Financial Coordinator must be able to work as a team and independently with efficiency, and exercise excellent judgment skills.


The Transplant Financial Coordinator is a member of the multidisciplinary transplant team and has primary responsibility for coordinating financial aspects of care throughout all phases of the transplant process. The Financial Coordinator acts as a resource and financial counselor for transplant candidates and their families, providing financial guidance in a compassionate and tactful manner in order to help facilitate access and provide continuity of care. The Financial Coordinator works extensively with the transplant team members, third party payers, government agencies, other funding agencies and hospital financial/billing staff. He/she facilitates transplant billing and provides quality service to patients by providing comprehensive and ongoing financial counseling and by identifying and helping to resolve financial coverage issues.



General duties


The Financial Coordinator supports all solid organs for financial needs throughout the necessary phases of transplant care.

• Meets with potential transplant patients to assess financial means and needs, and provide financial information and resources as needed. Assists with financial planning


• Obtains detailed patient insurance benefit information and assists with verification of coverage relating to all aspects of the transplant process, including but not limited to: evaluation, transplantation, outpatient prescription drug benefits, post-transplant services, out-of-pocket maximums, and travel and housing if necessary. Determines co-payment expectations and other potential out-of-pocket liability.


• Serves as a resource for patients and family members on financial matters throughout the transplant process. Works with patients, their families, and transplant team members to address insurance coverage gaps and issues and investigates alternative funding options as necessary.


• Advises transplant candidates on insurance and funding options including providing information regarding alternate funding and choices of insurance coverage i.e., Medicare and Medicaid eligibility, COBRA, Social Security Disability, retirement plans, etc. Provides information to patients regarding available medication assistance programs and assistance with co-payments, and organizations that can assist with fund-raising. Assists with applications, eligibility guidelines and other necessary paperwork or process issues to access such assistance.


• Keeps apprised of changes in federal and state (FDA/HFCA, etc.) guidelines and policies related to organ transplantation.


• Obtains all necessary payer authorizations, verifies transplant coverage and other medical benefits as needed for pre/post transplant and VAD patients.


• Monitors and updates information regarding insurance data, authorizations, and preferred providers on a regular basis. Follow-ups with patients throughout the transplant process as necessary for financial needs.


• Working with hospital staff and division finance/billing staff, facilitates resolution of patient billing issues.


• Keeps clinical staff informed of all patient financial information and alerts staff to any issues that may impact patient's ability to undergo services during the transplantation process.


• Serves as a routine resource to the Transplant team and provides explanation to the clinical and administrative staff in regard to transplantation reimbursement criteria and insurance coverage.


• Participates in transplant program multi-disciplinary and/or other patient management meetings and is prepared to provide pertinent financial information.


• Responsible for managing the charge router, patient (account holds, registration, DNB, etc.) and organ acquisition work queues in EPIC.


• Review the prior 24-hour admission patient list to support Transplant patient transfers with the admit team when appropriate.


• Acts as a point person for contract billing for service agreement such as Boston Children's Hospital, VA and/or Mass General.


• Participates in patient orientation sessions and/or other patient information forums as required.


• Monitor provider enrollment.


• Sends out weekly open encounter reports for transplant encounters to ensure encounters are closed in a timely manner per compliance billing.


• Acts as a billing coordinator to support coding and billing inquiries.


• Maintain aging work queue reports, denial and relevant reports.


• Ability to run epic reports in relation to billing or insurance per organ.


• Daily review of epic reports or work queues to identify patient phase and assist with waitlist management.


• Document efficiently in epic, including scanning all associated documents and update prior authorization and or referral information into EMR (including PHX templates).


• Coordinate with other services throughout the institution when applicable.


• Work closely with the admission and cath lab teams.

Team Lead

• The Senior Financial Coordinator assists with running daily or weekly huddles and financial work queue management


• He/she acts as a lead to the team for new hires, onboarding and point of contact for urgent matters and or quick resolutions.


• Can adapt to the financial needs throughout the service line when appropriate including providing cross coverage


• Sits in for financial meetings in the absence of the financial supervisor.


• Lead service line and or program initiatives within the group.

• Acts as an epic superuser and finds ways to optimize our applications and resources


• Assign daily coverage assignments as needed including creating a coverage plan.


• Maintains shared mailbox and faxcom for completion rate.


• Point person for National Kidney Registry tracking for hospital and professional billing.


• Works closely with the Financial Supervisor for best practice and to assist with team building.


• Assist and may lead education sessions for the service line as needed


• Helps compile Medicare time studies and contributes to monthly staff meetings


• Joins institutional billing and or payer meetings for professional growth and to share with the team to optimize communication.

Other duties:

• Participates in weekly transplant team conferences.


• Participates in Process Improvement initiatives or data projects.


• All other duties as assigned.

Qualifications

Qualifications - External

• Bachelor's Degree strongly preferred. Significant directly relevant experience will be considered in lieu of degree.


• Minimum of 3 years direct experience with healthcare insurance benefits, preferably in a hospital setting. Experience with transplant financial issues and/or insurance coverage a strong plus.


• Demonstrated strong experience working effectively with patients, doctors and nurses.


• Knowledge of hospital, industry and agency standards for procedures used to collect, compile and manage/coordinate data.


• Very familiar with Microsoft Office, preferrable Microsoft Access or another database software.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:



• A broad and thorough knowledge of


o organizational strategies/theory and practice


o strategic thinking to adapt to the high demand in tasks and collaboration


o information systems (i.e. EPIC modules, Windows applications, spreadsheets, PowerPoint etc.)


• Strong communications skills.


• Ability to focus detailed, concentrated effort to multiple tasks and re-establish priorities as necessary.


• Ability to effectively respond to time sensitive issues.


• Demonstrate the ability to take initiative and provide critical thinking.


• Ability to work effectively in a team and multi-disciplinary environment. Apply Now