FINANCIAL ACCESS REGISTRATION SPECIALIST

FINANCIAL ACCESS REGISTRATION SPECIALIST

Description:
About Our Organization

Partners HealthCare is an integrated health care system founded by Brigham and Women's Hospital and Massachusetts General Hospital. In addition to its two academic medical centers, the Partners system includes community and specialty hospitals, community health centers, a physician network, home health and long-term care services, and other health-related entities. Partners is one of the nation's leading biomedical research organizations and a principal teaching affiliate of Harvard Medical School. Partners HealthCare is a not-profit organization. We have opportunities in Finance, Information Systems, Human Resources, and many other areas that work behind the scenes in support of the Partners mission.

General Overview

**Located at Spaulding Hospital Cambridge** Responsible for the smooth coordination and documentation of patient referral information within a Centralized Financial Access unit supporting the Spaulding Rehabilitation Network admissions flow for patients referred from multiple sources. Involves working closely with Liaison Representatives, Financial Service Counselors, Financial Access Specialists, referral sources/case managers, insurance case managers, patients and family members to ensure accurate admission/registration, maximum cash flow and reimbursements for the system. As the initiators of patient records, they must be competent with Medical Record Number assignment as well as understand revenue cycle. Verifies and enters all data related to the patient and ensures all data is accurate. They will be responsible to pre-register all admissions info into the various SRN information systems.

Responsibilities

1. Works closely with Spaulding Rehabilitation Network (SRN) Financial Access Team Lead and Financial Access Specialists to coordinate the financial access process for patients referred to the SRN for inpatient care.

2. Work closely with SRN Admission Directors and Financial Access Team to coordinate the financial clearance process for patients referred to the SRN for inpatient care.

3. Manages the electronic information for each patient referred via the entity Information system, the 4NEXT referral systems and Sharepoint. Will be cross trained in all the Information systems (Meditech, HIS/GOLD, Keane) used within the SRN. Keeps applicable databases updated with accurate demographic and financial information as well the current status of each referral. Consults with Information Systems and/or department Team Leader or Director for any questions regarding these information systems.

4. Assesses and verifies insurance benefits and eligibility with insurance carriers and government agencies using NEHEN and other means to determine level of benefits for each patient referred to the SRN. Calculates Medicare benefits using their electronic insurance eligibility payer websites.

5. Assists Financial Access Specialists with follow-up calls regarding prior authorizations for admission from managed care companies by calling insurance case managers. Assures that there is financial coverage for an inpatient rehabilitation stay prior to placing the patient in the queue for a bed assignment. Understands the specifics and nuances of each insurance contracts admission procedures and follows accurately to assure payment for the inpatient stay.

6. Takes independent action to ensure all information is obtained and complete or benefit levels are adequate to ensure reimbursement for the care provided.

7. Understands each managed care contract, coordinates and consults with the Director of Financial Access Management, Financial Access Lead, Financial Counselor, and/or the Financial Access Specialist when levels of care, rate negotiations or carve-outs are indicated to assure maximum
Qualifications: