Admissions Counselor / 40 hour / Day / BWH Inpatient Accounts - Assembly Row
Company: Brigham and Women's Hospital
Posted on: September 24, 2022
GENERAL SUMMARY: Under the direction of the Supervisor, the
Admission Counselor is responsible for 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 pre-admission approvals and pre-certifications,
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 of
booking, 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. Potential to work from home in a hybrid capacity once
fully trained and will be expected to be onsite 1-3 times per week.
PRINCIPAL DUTIES AND RESPONSIBILITIES: 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
pre-admission approvals pre-certification. Monitors pending cases
to ensure that approvals are obtained prior to visit. Advises
uninsured and underinsured patients regarding available programs.
Makes appropriate referrals to Patient Financial Services
Department. 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 institution. 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 information.
Adhere 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 sending faxes. Performs
special projects as assigned. Bachelor's degree or equivalent
preferred; high school diploma required. Proven experience in like
setting is acceptable in lieu of educational requirements. 1-2
years experience in hospital billing and reimbursement preferred.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: 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 established policies. 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, etc. WORKING CONDITIONS: Hectic office
environment, noisy, fluctuating temperature and high volume
activity. FISCAL RESPONSIBILITY: Promote institutional financial
stability based on throughput and data integrity.
Keywords: Brigham and Women's Hospital, Somerville , Admissions Counselor / 40 hour / Day / BWH Inpatient Accounts - Assembly Row, Other , Somerville, Massachusetts
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