Patient Financial Coordinator

• Job Type: Officer of Administration
• Bargaining Unit:
• Regular/Temporary: Regular
• End Date if Temporary:
• Hours Per Week: 35
• Standard Work Schedule:
• Building:
• Salary Range: $62,400-$75,000

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.

Position Summary

This Patient Financial Coordinator (PFC) acts as a crucial member of our OBGYN revenue cycle team and the IVF teams to coordinate the financial aspects of the patient's care while working together with our other dedicated team members in creating a positive and memorable patient experience. The PFC ensures patients are well educated about the financial and insurance aspects of their care, and that steps are taken by the practice to ensure proper payments are received from the patient or the patient's insurance company on a timely basis. The PFC serves as a resource to patients regarding financially related matters such that they are accessible to patients for ongoing questions regarding the aspect of their care.

Responsibilities

• Acts as a liaison between the financial coordinators, Patient Associates III, and Revenue Cycle schedulers, by ensuring appointments are correctly marked as "arrived" or "no show."

• Review complex claim denials for REI.

• Transports check from Columbus Circle to the Clinical Revenue Office in Fort Lee.

• Additional tasks as required by the Revenue Cycle Manager.
• Serve as the patient's primary contact on financial matters throughout the course of treatment, including conducting new patient outreach, providing financial consults at each stage of the treatment, securing financial consents, providing requested documentation, and answering patient questions.
• Ensure that insurance information has been correctly entered into Epic and EMR.
• Review the physician's schedule daily to ensure all new patients have received their insurance verification information and introduction email.
• Review patient insurance coverage, follow up with the insurer to confirm key information, and investigate any discrepancies in information given to the practice and patient.
• Guide and educate patients on insurance medical criteria, and expected and actual fund usage throughout treatment to ensure understanding of coverage and upcoming out-of-pocket payment responsibilities.
  
  • Examples of medical criteria that need to be met for patients to access IVF benefits; BCBS of NJ policy; if there is no male/female factor patients 35 and under must do 2-3 IUI (Must use injectable meds) patients 36 and over must do 2 IUIs. Also, for ICSI to be covered, the partner must have 2 abnormal semen analyses (Morphology 3% or less and concentration must be less than l/million). Oxford, Aetna, UHC, & Emblem HIP do not allow banking, meaning patients cannot move forward with a second IVF cycle if the have normal embryos from the first cycle.
• Ability to understand and interpret simulation reports and communicate financial implications.
  • Examples: PFC must be able be identify the different treatment plans and additional recommended procedures for each patient's treatment plan; IVF Fresh cycles, IVF Embryo Freeze-all with or without Assisted Hatching, PGTa/m/sr, ICSI, ZYMOT, Frozen embryo transfers with PRP. PFC must be able to identify how many normal and abnormal embryos were created within each cycle by interpreting terminology such as euploid and aneuploid. PFC needs to interpret when the patient is set up for a cycle, where they are in a cycle, what services were completed and not completed, and how it affects their fund usage.
• Discuss pricing with patients based on the various cycle types and payment options.
• Initiate financial clearance processes for treatment; review account and confirm all required diagnostics were completed, perform pre-authorizations for services as needed, understand the codes that need to be requested and submit the medical records that are required based on the insurance, and communicate patient responsibility amounts and insurance authorization turnaround time to the patients, in advance of related procedure.
• Calculate out of pocket expenses based on remaining lifetime maximum coverage, deductible, co-insurance, copays and collect payment as needed.
• Track application of funds throughout treatment process.
• Proactively resolve any inaccurate fund disbursements and billing discrepancies in collaboration with the billing team.
• Serve as a resource to Patient Account Representatives to answer calls and/or emails as it pertains to billing questions, financial policies, claims submission and any other finance related issue.
• Serve as a resource to care team (ND, RN, Care Coordinator, Medication coordinator) regarding potential impact of insurance coverage limitations on care plan. Attend and contribute to care team meetings.
• Proactively maintain knowledge of insurance policies and guidelines for infertility care.
• Request pre-authorizations for outside procedures such as MRIs done radiologists, PGTm/sr genetic testing on Juno's behalf, Anora genetic testing on Natera's behalf.
• Facilitate insurance appeals, coordinate peer to peer calls with the insurance and our MD. Submit letters of medical necessity and additional supporting medical records.
• Manually create itemized invoices for flex spending reimbursement.
• Perform all other duties as assigned within the professional scope of practice/training/education.
• Escalate complex patient situations requiring special handling as appropriate.
• Responsible for briefly counseling patients on outside costs such as for Natera, Juno, Genescreen, pharmacies, etc.
• Guide patients on trouble shooting outside bills by providing contact information for outside labs. Escalate outside billing issues to upper management.
• Work on additional tasks as required by upper management

• Strategy and Project Management
  
  • Participate in a culture of continuous improvement by identifying opportunities, proposing project ideas, and collaborating on projects and initiatives to meet team goals and improve team processes and procedures. Utilize tools and reporting mechanisms to track progress and ensure timely communication of issues and status. Provide administrative support for projects as needed.
  • Conduct research to collect up-to-date information about insurance policies and guidelines for infertility care. Create and update internal resources as assigned and report out to team. Maintain ownership over specific resources as assigned.

• People
  • Promote staff professionalism and performance by modeling behavior, team accountability and demonstrating best practices/techniques. Participate in a culture of coaching and mentoring to facilitate continuous professional development and maintain an efficient patient-centered environment that fosters accountability, quality patient care, and patient satisfaction.
  • Mentor new staff and assist with training as assigned.
• Other
  • Keep current on all organizational, practice, and patient privacy policies (e.g., HIPAA), goals, initiatives, and required trainings.
  • Successfully complete all required university and department trainings.
  • Perform other related duties and responsibilities as assigned/requested.

Minimum Qualifications

• Bachelor's degree or combination of education and experience.

• Ability to understand and apply basic math skills.

• Ability to build rapport with and communicate effectively in both oral and written form with patients, professional staff, and providers. Strong customer service orientation, with the ability to deliver consistently exceptional service.

• Excellent relationship management skills including, but not limited to, emotional intelligence, interpersonal skills, empathy, and ability to handle situations with respect, tact, and sensitivity.

• Ability to stay organized and handle multiple tasks simultaneously in an accurate and timely manner.

• Ability to work independently and follow through.

• Proficiency in problem assessment and collaborative problem-solving in interdisciplinary settings.

• Ability to work with a variety of individuals and groups constructively and respectfully while appreciating the unique contributions of an inclusive workforce that brings together the talents of people across multiple identities.

• Strong commitment to fostering diversity and equity.

• Proficiency with Microsoft Office (Word and Excel) or similar software is required and an ability and willingness to learn new systems and programs.

• Must be a motivated individual with a positive mindset and exceptional work ethic.

• Must successfully complete systems training requirements.

Preferred Qualifications
• Minimum of 3 years experience working within an OBGYN practice; Infertility experience.
• Minimum of 3 years experience with insurance verification, insurance authorizations, and case management.
• Previous experience with direct patient contact/coordination/scheduling.
• Knowledge of EPIC and other electronic medical records

The Department of Obstetrics and Gynecology is dedicated to the goal of building a multicultural faculty and staff committed to teaching, working, and serving in a diverse community, and strongly encourages applications from candidates of traditionally underrepresented backgrounds.

We are continuously seeking to recruit individuals who will enhance the diversity of our workplace and the effectiveness of our organization.

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.

Commitment to Diversity

Columbia University is dedicated to increasing diversity in its workforce, its student body, and its educational programs. Achieving continued academic excellence and creating a vibrant university community require nothing less. In fulfilling its mission to advance diversity at the University, Columbia seeks to hire, retain, and promote exceptionally talented individuals from diverse backgrounds.