Patient Accounting Billing Solutions Representative

Overview

The primary functions of the Patient Accounting Billing Solutions Representative are to handle incoming patient-related calls, manage credit and collections activities, coordinate the Medicare Bad Debt program, copay assistance program, and administer the hospital Patient Financial Assistance program. This includes researching patient payments, insurance denials, and any overpayments.

The Patient Accounting Billing Solutions Representative conducts appropriate research activity, utilizing billing and follow up skills, and collaborate interdepartmentally to provide a conclusive response to the patient in a timely and effective manner. Work is primarily driven by system-based work queues in Epic. Accounts resolution typically requires expertise in multiple modules in Epic.

The Patient Accounting Billing Solutions Representative collaborates with Access Management to provide patients adequate financial assistance, correct demographics/registration errors, and add guarantor accounts or insurance policies as needed. Coordinates billing and follow-up activities for patients on co-pay assistance programs.

T he selected candidate must live and work from one of the New England states (ME, NH, VT, MA, RI, CT)

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Responsibilities

Under moderate supervision, responsible for routine customer service and follow-up activities:

• Coordinate all account activity when balance becomes patient responsibility, including communication with the patient and, if applicable, guarantors and collection agencies through:
  • Emails,
  • Phone calls/voice mails,
  • MyChart messages (Epic in-basket).
• Coordinate collections referral process for patients with outstanding balances. This may include setting up payment plans or referring the patient to resources offered by the Institute.
• Reviews Patient accounts to ensure third party follow-up has been complete in advance of collection activities.
• Resolve and/or directs requests from external sources (e.g., detailed bill requests from attorney offices).
• Conduct proper collection and/or write-off of patient account balances according to DFCI policy.
• Review, initiate and process self-pay refunds.
• Collections, and billing experience to gather and interpret relevant information to resolve patient account issues and complaints.
• Review and resolve patient correspondence through various WQs.
  • Bankruptcy notices,
  • Disputed balances,
  • Return mail– Sort and assign,
  • General correspondence – Sort and assign.
• Follow guidelines to correctly assess HSN Surcharges for applicable services. Review and post the state HSN surcharges as per established guidelines.
• Perform daily cash drawer reconciliation for both internal and agency credit card payments.
• Coordinate patient inquiries across departments to ensure patient questions are addressed in a timely manner.
• Review patient accounts to ensure all payments are accurately posted in advance of collection activity.
• Work closely with clinical trials team ensuring that patient questions are addressed in a timely manner.
• Initiate Financial Assistance cases and retrieve related documents from health logic and save them in Teams shared folder.
• Open and resolve CRM cases to track top departmental issues.
• Handle special projects as assigned by manager.
• Monitor all communication tools to ensure that all staff members are responding in a timely manner.
• Monitor Health Logic (i.e., remittance, correspondence, etc.) and Epic work queues to ensure that they are being worked on timely and appropriately.
• Manage issues grid and shares with management every week.
• Collaborate with Access Management to provide patients adequate financial assistance, correct demographics/registration errors, and add guarantor accounts or insurance policies as needed.
• Coordinate billing and follow-up activities for patients on co-pay assistance programs.
• Perform other duties as assigned.

Qualifications

• Minimum Education:
  • High school diploma required; bachelor’s degree preferred.
• Minimum Experience :
  • 5 years of experience in a similar billing solution setting required.
  • Knowledge of insurance follow-up and third-party billing requirements, practices, and procedures is required. Strong working knowledge of MS Excel.
  • Knowledge and experience in Epic specialty billing preferred.
• License/Certification/Registration:
  • N/A

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

• Strong communication and organizational skills.
• Ability to handle stressful contact with patients.
• Ability to operate computer software packages.
• Strong interpersonal skills to effectively communicate with cross functional teams, including staff at all levels of the organization.
• Ability to support and demonstrate the values of DFCI by conducting work activities in an ethical manner with integrity, honesty, and confidentiality. Ability to exercise strong confidentiality with patient information.
• Familiar with federal and state requirements for the collection and adjustment of patient accounts.

At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong. As relentless as we are in our mission to reduce the burden of cancer for all, we are equally committed to diversifying our faculty and staff. Cancer knows no boundaries and when it comes to hiring the most dedicated and diverse professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.

Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.