At BCH, success is measured in patients treated, parents comforted and teams taught. It's in discoveries made, processes perfected, and technology advanced. As a teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed team and discover how your talents can change lives.
This position will:
Respond to patient/guarantor concerns which span a wide range of issues including payer denials, coding accuracy/appropriateness, secondary billing, Coordination of Benefits, verification of co-payments/co-insurance/deductibles and verification/updates to demographic and fiscal registrations in order to verify the patient's responsibility for all outstanding balances
Provide timely, professional, and accurate account review, analysis, and resolution of patient inquiries
Obtain information and perform actions on a variety of systems including physician organization systems (EPIC PB), eligibility verification systems (NEHEN, payer web sites)
Effectively handle all communications. Follow through on commitments and achieves desired results
Identify root causes of guarantor/patient inquiries and report findings to management for appropriate resolution to future accounts
Follow established regulations and procedures in collection, recording, storage and handling of information
Protect and preserve confidentiality and integrity of all information according to BCH HIPAA confidentiality policy
Support and demonstrate the values of the BCH and affiliates
Consistently answer calls at the average of the daily rate for the team, typically at least 70-80 calls per day
Maintain a daily list of all accounts accessed. Provide supervisor/manager with an account listing of all unresolved issues weekly
Manage/resolve at least 80% of patient issues without referring the call to the supervisor/manager
Pass routine quality assurance reviews at an average of >90%
To qualify, you must have:
A High School diploma or GED equivalent
Associates Degree preferred
Epic billing systems knowledge preferred
Effective communication, organizational and problem solving skills
1-3 years relevant experience in customer service or collections in a health care setting strongly desired
Familiarity with medical/hospital billing systems and third party payment processes desired
Familiarity with Epic PB and SSC functions either due to prior training or through a combination of training classes and peer-to-peer training
Knowledge of Word, Excel, and Outlook to perform all routine tasks including email, document preparation and worksheet preparation
HIPAA Privacy guidelines
Good verbal and written business communications skills to clearly document issues/communicate with patients
The PAR resolves guarantor/patient account balances. The Shared Service Center's primary focus includes both timely responses to guarantor/patient inquiries via a variety of paths and outreach efforts to resolve open guarantor accounts. The call center is the primary point for all inbound contacts from our patients. The PAR utilizes multiple electronic billing and medical retrieval systems as well as knowledge of medical billing to resolve guarantor/patient inquiries. The PAR must be able to respond knowledgeably to a wide range of patient issues for every contracted and non-contracted payer, including government and non-government payers, to resolve account balances. Our goal is to resolve all of the patient's concerns while maintaining positive relationships with the guarantor/patient by providing the best possible service to all our customers thereby enhancing the overall engagement with the patient.
BCH is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.