Senior Patient Finance Representative

Boston Children’s Hospital; Boston (MA); Remote; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a Senior Patient Finance Representative to join their dynamic team. In this fully remote role, you will manage financial clearances and insurance verifications, ensuring compliance with regulations and hospital policies. Your strong communication and customer service skills will be vital as you engage with patients and collaborate with clinical departments to secure necessary authorizations. Enjoy a competitive salary and a comprehensive benefits package, including flexible schedules and generous time off, while making a meaningful impact in patient finance.

Benefits

Flexible Schedules

Affordable Health Insurance

Vision Insurance

Dental Insurance

Child Care Subsidies

Student Loan Subsidies

Generous Time Off

403(b) Retirement Savings Plan

Pension

Tuition Reimbursement

Qualifications

• 1+ year of experience with health insurance, referrals, and authorizations.
• Strong communication skills and empathy in difficult situations.

Responsibilities

• Manage daily assignments for financial clearance and insurance verification.
• Collaborate with clinical departments to ensure timely authorizations.

Skills

Communication Skills

Customer Service Skills

Problem-Solving

Organizational Skills

Attention to Detail

Education

High School/GED

Tools

Patient Accounting System

Job description

Job Title: Senior Patient Finance Representative

The Senior Patient Finance Representative will be responsible for:

1. Managing daily assignments using standardized protocols and work queues to ensure timely completion of financial clearance in accordance with departmental processes and payer guidelines.
2. Collecting, verifying, and recording all demographic information required for patient financial clearance in accordance with hospital policy.
3. Verifying insurance eligibility utilizing available technologies, payer websites, or by phone contact with third-party payers, and working in accordance with required State and Federal regulations and hospital policies.
4. Ensuring that correct insurance company name, address, plan, and filing order are recorded in the patient accounting system.
5. Using payer exception reports to update coverage / PCP information.
6. Contacting PCP (primary care physician) offices to secure referrals and entering referrals into the patient accounting system.
7. Collaborating with clinical departments, case managers, and clinical liaisons to ensure payer authorizations are obtained timely.
8. Proactively engaging patients and family members to determine coverage limitations and financial liability.
9. Communicating with physician offices, service sites, and ancillary departments if referrals/authorizations are denied at least 72 hours prior to the service date.
10. Facilitating peer-to-peer reviews when needed to secure authorizations.
11. Documenting all actions taken on accounts with clear and concise account notes.
12. Participating in process improvement activities.

Qualifications:

• High School/GED required.
• At least 1 year of direct experience working with health insurance, referrals, and authorizations.
• Effective communication skills in English, both oral and written, with empathy in difficult interpersonal situations.
• Ability to resolve complex problems using basic scientific, mathematical, or technical principles.
• Strong customer service skills and good understanding of computer systems. Familiarity with basic medical terminology.
• Organizational skills and ability to work efficiently in a fast-paced environment to meet deadlines.
• Attention to detail and accuracy in completing tasks.
• This is a fully remote position.

Boston Children’s Hospital offers competitive compensation and comprehensive benefits, including flexible schedules, affordable health, vision, and dental insurance, child care and student loan subsidies, generous time off, 403(b) Retirement Savings plan, Pension, Tuition and License/Certification Reimbursement, cell phone plan discounts, and discounted T-pass rates. Join us to experience the benefits of passion and teamwork.