Senior Patient Finance Representative

Boston Children's Hospital; Massachusetts; Hybrid; USD 40,000 - 80,000; Full time

Job summary

An established industry player is seeking a Senior Patient Finance Representative to manage financial clearance processes. This fully remote role requires effective communication skills and a strong understanding of health insurance. You will be responsible for verifying insurance eligibility, collaborating with clinical departments, and engaging with patients to clarify coverage limitations. The position offers competitive compensation and unmatched benefits, including flexible schedules and generous time off. Join a passionate team dedicated to improving patient financial experiences.

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 direct experience with health insurance, referrals, and authorizations.
• Ability to communicate effectively in English both orally and in writing.

Responsibilities

• Manage daily assignments for financial clearance in accordance with policies.
• Verify insurance eligibility and document all actions taken on accounts.

Skills

Customer Service Skills

Communication Skills

Problem-Solving Skills

Attention to Detail

Organizational Skills

Education

High School/GED

Tools

Patient Accounting System

Payer Websites

Job description

The Senior Patient Finance Representative will be responsible for:

• Managing daily assignments using standardized protocols and work queues to ensure timely completion of financial clearance in accordance with departmental processes and payer guidelines.

• Collecting, verifying, and recording all demographic information required for patient financial clearance in accordance with hospital policy.

• 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.

• Ensuring that correct insurance company name, address, plan, and filing order are recorded in the patient accounting system.

• Using payer exception reports to update coverage / PCP information.

• Contacting PCP (primary care physician) offices to secure referrals and entering referrals into the patient accounting system.

• Collaborating with clinical departments, case managers, and clinical liaisons to ensure payer authorizations are obtained timely.

• Proactively engaging patients and family members to determine coverage limitations and financial liability.

• Communicating with physician offices, service sites, and ancillary departments if referrals/authorizations are denied at least 72 hours prior to the service date.

• Facilitating peer-to-peer reviews when needed to secure authorizations.

• Documenting all actions taken on accounts with clear and concise account notes.

• Participating in process improvement activities.

To qualify, you must have:

• High School/GED is required.
• 1 year of direct experience working with health insurance, referrals and authorizations is required.
• Ability to communicate effectively in English both orally and in writing and provide empathy in difficult interpersonal situations.
• Ability to resolve complex problems requiring the use of basic scientific, mathematical, or technical principles is required.
• Well-developed customer service skills and a good understanding of computer systems are required. Familiarity with basic medical terminology is required.
• Effective organizational skills and the ability to work in a fast-paced environment to ensure completion of work within established timeframes.
• Attention to detail and completion of tasks with accuracy.
• This is fully remote position.

Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

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