Patient Service Coordinator III- REI/ IVF

Massachusetts General Hospital
United States, Massachusetts, Boston
32 Fruit Street (Show on map)
Jan 28, 2025
Working closely with and reporting to the Practice Manager ensures that patient demographic and financial information is complete in the hospital's registration and billing systems by working directly with the patient, physicians, Patient Accounts, and third-party payers. The Patient Services Coordinator determines eligibility and obtains insurance authorizations and pre-certifications from third-party payers for all services and procedures. Understands HMO, PPO, Medicare, Medicaid, and other third-party insurers. Understands financial services and self-pay resources and provides patients with relevant information Functions as a resource for patients and staff around managed care plans, insurance, and referral/prior authorization issues and possesses the ability to perform electronic insurance verification Reviews medical and financial clearance submissions and submits Prior Authorizations or Pre-Certifications to third-party payers for infertility procedures/services In partnership with the MGPO Professional Billing Office (PBO), maintains a list of MGH-accepted insurance plans and master charge lists, and cost estimates for patient visits Monitors Epic encounter completion and ensures encounter closing with providers to ensure timely completion of notes and billing Reviews charges in the work queue and submits billable visits in conjunction with the Practice Manager Responsible for billing all deliveries for the entire IVF/REI Division, which includes emailing providers for missing charges and/or encounters Education High School Diploma or Equivalent required Experience office experience 3-5 years required Knowledge, Skills and Abilities - Strong technology and MS Office skills - Advanced Outlook, Word, Excel, PowerPoint Knowledge of office operations and standards and understanding of office procedures including filing, copying, scanning, printing and faxing. - Ability to use phone system and manage more non-routine phone calls and solve routine issues as appropriate. - Communicating effectively in writing as appropriate for the needs of the audience and talking to others to convey information effectively. - Understanding written sentences and paragraphs in work related documents, to correspond and communicate with others clearly and effectively (including composing/editing e-mail, memos and letters), and to take complete and accurate messages. - Managing one's own time and the time of others. - Well organized and good time management skills to manage multiple tasks effectively, follow established protocols, and work within systems. - Ability to proofread and edit written documents. Physical Requirements* Standing Occasionally (3-33%) Walking Occasionally (3-33%) Sitting Constantly (67-100%) Lifting Occasionally (3-33%) 20lbs - 35lbs Carrying Occasionally (3-33%) 20lbs - 35lbs Pushing Rarely (Less than 2%) Pulling Rarely (Less than 2%) Climbing Rarely (Less than 2%) Balancing Occasionally (3-33%) Stooping Occasionally (3-33%) Kneeling Rarely (Less than 2%) Crouching Rarely (Less than 2%) Crawling Rarely (Less than 2%) Reaching Occasionally (3-33%) Gross Manipulation (Handling) Constantly (67-100%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) The General Hospital Corporation is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.