When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.
Job Summary: Under the direction of the Director, Outpatient Clinics provides administrative support to the outpatient specialty clinics. Verifies insurance eligibility, benefits, referral and authorization requirements for the Clinics. Ensures all exams requiring a Prior Authorization and/or Referral are coordinated through the appropriate insurance provider or intermediary, and documents in electronic medical record. Requires knowledge of CPT codes and ICD-10 codes. Provides administrative support for physicians by answering and screening telephone calls, and taking accurate messages. Schedules patient surgeries, coordinating and communicating with other hospital staff as needed. Types correspondence, manuscripts and documents that may require complex formatting. Checks in patients in CCC as needed. Schedules office appointments and imaging exams as necessary. Manages physician billing as needed. Provides support to Department Chief or higher level surgeon or physician.
The highest regard for patient confidentiality is an expectation at all times. Acts in a professional manner and puts patient needs first.
Job Description:
Essential Responsibilities:
Secures all required prior authorizations and documents in OMR. Makes follow up calls to prior authorization agents as needed to ensure timely turnaround of prior authorization documentation.
Completes forms including disability, back to work and FMLA for patients.
Responsible for interviewing patients or their representative, obtaining personal information or verifying information already on file, including emergency numbers, next of kin, employer and insurance information.
Secures all referrals for outpatient clinic visits and documents in OMR, may include medical clearance, physical therapy, etc.
Prepare all medical records, as requested from attorneys and set up all peer to peer reviews for Physicians, as needed.
Secures approval for surgery and ensures medical clearance prior to surgery.
Schedules patient surgeries, including worker's compensation surgeries, coordinating and communicating with other hospital staff as needed.
Inputs Physician billing charges into Meditech system on a daily basis.
Maintains Physician Administrative calendar and clinical calendars. Types correspondence, manuscripts and documents that may require complex formatting. Composes routine correspondence. May include documents and manuscripts that support Physician's academic responsibilities, as well as, clinic needs.
Performs check-in, registration, and verification of demographic and fiscal information. Collects copayments from patients at point of service.
Required Qualifications:
High School diploma or GED required.
Equivalent related experience and education combined may be substituted for H.S. Diploma/GED.
3-5 years related work experience required in in a hospital financial setting, or clinical setting required.
Ability to work independently with minimal supervision.
Must possess a strong focus on teamwork, strong organizational skills, and the ability to multi-task to meet defined timelines.
Ability to read and communicate effectively in English.
Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
Preferred Qualifications:
Understanding of hospital collections preferred.
Competencies:
Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.
Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.
Written Communications: Ability to communicate clearly and effectively in written English with internal and external customers.
Oral Communications: Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.
Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.
Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.
Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.
Age based Competencies:
Employees in this job must be competent to provide patient care to the following age groups: Neonatal:Birth to 6 months, Youth: 6 months to 16 years, Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 -.
Physical Nature of the Job:
Light work: Exerting up to 20 pounds of force frequently to move objects. Some elements of the job are sedentary, but the employee will be required to stand for periods of time or move through out the hospital campus
Pay Range:
$21.00 - $28.26
The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.
As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.
More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.
Equal Opportunity Employer/Veterans/Disabled
