Team Lead / 40 hours / Days / BWH Inpatient Accounts - Assembly Row
Company: Brigham and Women's Hospital
Posted on: January 16, 2022
Under the direction of the Supervisor, is responsible for all
the responsibilities of the Admissions Counselor position which is:
ensuring the timely, accurate processing of patient accounts,
focusing on the "up front" activities. The Admission Counselor
verifies and/or collects required data, assuring its accuracy and
integrity. Reviews scheduled visits to determine financial
requirements. Obtains appropriate preadmission approvals and
precertifications, confirming that third party requirements are
met, prior to visit. Identifies cases which might place the
institution at financial risk and recommends delay or deferral of
non-emergent cases until financial issues can be resolved.
Maintains account from time it hits Ontrac Work List, until the
bill is generated and is responsible for ensuring data quality, in
order to expedite billing and reimbursement process and minimize
financial risk to the institution.
In addition, the individual will act as a Department resource,
which may include assisting in the training of new hires, or the
retraining of existing hires. Will act as lead for teams, as
assigned, which can vary. Will assist Management team in projects
as necessary and assigned.
- Acts as lead to teams, as assigned.
- Runs reports, as assigned.
- Acts as resource for training new and/or existing
- Works projects related to the Inpatient Accounts Department, as
- Assists in the review of staff denials, as assigned.
- Acts as a Subject Matter Expert for the Department, and may be
asked to participate in meetings, as necessary.
- Verifies and/or collects demographic and financial information
on all scheduled visits. Enters/edits data on-line as needed,
ensuring its accuracy and integrity.
- Contacts insurance companies, managed care plans and outside
agencies to verify insurance coverage and benefits. Determines if
any pre-admission/pre-visit requirements exist.
- Compiles and submits clinical information required to obtain
preadmission approvals precertification. Monitors pending cases to
ensure that approvals are obtained prior to visit.
- Makes appropriate referrals to Patient Financial Services
- Recommends delay or deferral for non-emergent cases until
financial issues can be resolved.
- Reviews and follows-up on all emergency and unscreened
admissions as soon as possible, but within 24 hours at the latest,
to identify and minimize financial risk to the
- Maintains patient confidentiality and privacy by accessing
patient information only to the extent necessary to fulfill
assigned duties. All patient information must be kept private,
confidential and secure. All lists, reports, files and documents
must always be properly secured and stored. Interviews and
examinations should be conducted in such a manner as to afford the
patient reasonable audio and visual privacy.
- Maintains effective working relationships and communicates
regularly with Social Service, Care Coordination and other
departments to update and exchange pertinent account
- Adheres to Customer Service Standards by demonstrating
professionalism, alertness, helpfulness, and receptiveness to all
patients, visitors and other staff members.
- Employs discretion when leaving answering machine messages, or
- Performs special projects as assigned.
- Bachelor's degree or equivalent preferred; high school diploma
- Proven experience in like setting is acceptable in lieu of
- 3-5 years' experience in a hospital setting, experience with
prior authorizations, billing and reimbursement helpful
- Interpersonal relationship skills necessary to communicate
effectively with patient/family, physicians and their support
staff, medical staff, nursing staff, other hospital personnel and
many external organizations and agencies.
- The technical knowledge of specific legal and regulatory
requirements and an understanding of complex third party and
medical assistance polices and procedures.
- Knowledge of the hospital information system with emphasis on
accounts receivables programs.
- Ability to function independently and prioritize work within
- Requires good judgment, tact, sensitivity and the ability to
function in a stressful environment.
- Ability to maintain confidentiality regarding the patients,
their medical histories, demographic and fiscal information,
Keywords: Brigham and Women's Hospital, Somerville , Team Lead / 40 hours / Days / BWH Inpatient Accounts - Assembly Row, Other , Somerville, Massachusetts
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