New Patient Coordinator - South Shore Health

Job Description Summary

The New Patient Coordinator/Financial Counselor (NPC/FC) reports directly to the Operations Manager and is responsible for facilitating the new patient's appointment/care with DFBWCC in clinical affiliation with South Shore Hospital. These functions may include, but are not limited to, collecting initial clinical data, collecting demographic and insurance information, providing clear and accurate financial information/options, and scheduling the initial visit. Contact with the new patient is the first introduction to the practice, and, as such, requires good interpersonal skills, a calm communications style, friendly responsiveness and efficient management of the patient encounter. He/she is expected to exhibit professional behavior through adherence DFCI, and site-specific policies, procedures, and codes of conduct. The NPC/FC will provide coverage/assistance as needed to the Practice Coordinators as requested by management staff. The NPC/FC will coordinate directly with the Dana-Farber Access Management staff at the Longwood campus, as appropriate, to process insurance eligibility, referrals, authorizations and financial counseling, working together to promptly assist the patient (and resolve discrepancies).

Job Description

Essential Functions:

1 - Clinical Intake and Scheduling

   a - Guide patient through the appointment process, including expectations of the first appointment.

   b - Coordinate/obtain clinical documentation prior to the first visit, including medical records and reports from all prior applicable appointments, pathology slides, and/or radiology films.

   c - Understand the process of care and schedule appropriately for all clinical diagnoses. Consult with clinical staff as appropriate to determine urgency of first appointment for palliative or urgent cases.

   d - Knowledgeable of financial arrangements, insurance coverage, and billing procedures.

   e - Schedule appointments in Epic/Aria capturing demographic, insurance and disease information.

   f - Identify self-pay or high risk financial patients; coordinate financial counseling as necessary (self-pay, non-participating insurance coverage, potential high coinsurance).

   g - Mail or electronically send “new patient packets” to patients.

   h - Add referrals to referral tracking form and send appropriate end of day and weekly wrap up emails.

   i - Upload imaging CDs .

   j - Work closely with nursing and therapy to determine scheduling logistics including financial clearance, status board submission and scheduling of simulation for urgent patients.

k - Facilitate prior authorization for appointments as needed

l - Confirm all consultation appointments with patients via phone and answer any questions they may have

2 - New Patient Care Coordination

a - Carry out departmental quality assurance checks (e.g. consult notes) to ensure patient charts, documentation and care are complete and accurate.

b - Facilitate patient care process following consultation by ensuring that physicians enter status board request for simulation and treatment in a timely manner.

c - Monitor status board for approved cases and facilitate the scheduling of simulation. Ensure information from status board is transcribed into the patient simulation appointment.

d - Confirm all simulation appointments with patients via phone, provide appropriate appointment prep information and answer any questions they may have.

3 - Financial Intake and Counseling

   a - Works directly with identified new patients or directed established patients to obtain accurate demographic and financial information from self-pay and high financial risk patients.

   b - Utilize real-time automated tools for insurance verification, eligibility, and benefits information; may require contacting insurance carrier.

   c - Communicate with insurance carriers, study team, and/or other providers to obtain required information on the patient’s behalf.

   d - Compile and submit all necessary documents and data to support request for coverage of charges for services to be performed at DFCI.

   e - Communicate, as needed, with patients and/or their families to obtain financial information and/or address account concerns

   f - Work with DFCI Patient Access and LROC billing to obtain financial clearance.

   g - Document all patient account correspondence in the appropriate note field, designated forms, or databases; this includes all incoming and outgoing telephone calls, referral number data, and any other account knowledge that becomes available.

   h - Participate in patient estimate cost/pricing requests and collect necessary treatment/service deposits, co pays, and deductibles from self-pay or other high-risk patients,

   i - Accurately and courteously explain policies regarding financial assistance programs and assist patients/families in the completion of applications.

   j - Pursue coverage opportunities for uninsured and underinsured patients; assist patients and families in the completion of financial assistance applications.

3 - Financial Intake and Counseling (continued)

   a - Responsible for daily identification of problem accounts and handles resolution.

   b - Obtain same day insurance authorizations and referrals (services requested after 3:00 the previous day).

   c - Coordinate support with LROC billing and DFCI Patient Access to manage patient pre authorizations and referrals.

   d - Coordinate support for patients with financial issues including, but not limited to, investigating patients accounts and assisting patients/families and/or physicians with appeals for services in the event of a denied claim.

4 - CONFIDENTIALITY

   a - Regular exposure to patient demographic, diagnostic, and billing information.

   b - Exposure to physician information including physician numbers assigned by governmental agencies and insurance carriers.

   c - Institute contract information with third party payers.

   d - Institute financial information.

Job Requirements:

Minimum Education - Preferred

High school diploma/GED preferred. 

Associates degree or equivalent experience preferred.

Minimum Work Experience - Preferred

Prior hospital/physician office registration/billing experience preferred
Minimum of 2 years of financial experience in a hospital or ambulatory setting preferred

Oncology experience preferred

Required additional Knowledge, and Abilities

Knowledge of managed care policies and medical terminology preferred.
Working knowledge of Epic or other hospital/EMR systems
Strong understanding of Microsoft Office product suite.
Excellent customer service and communication skills, both written and verbal.
Self-starter with strong team player and leadership abilities.
Strong analytical, problem solving skills, mathematical/accounting skills.
Ability to prioritize and meet pre-determined deadlines.
Advanced technical skills, as appropriate.

Flexible hours required