The Non-Contracted Billing Coordinator, in conjunction with the Contact Services Optimization team, supports several ambulatory practices in improving their adherence around screening for non-contracted insurances. The Contact Services Optimization (CSO) team consults with all contact center Specialties of Brigham and Women's Hospital enterprise wide, to manage and optimize the patient experience through standardized contact center practices. To further support the work of the CSO team, the Non-Contracted Billing Coordinator team was created to aid in providing exceptional patient care, maintaining financial stability, and fostering positive relationships with Non-Contracted and Out-Of-Network (OON) patients with our practices, providers, and staff.

Reporting to the CSO Manager, the Non-Contracted Billing Coordinator (NCBC) will be responsible for managing communication of the participating practices non-contracted and out of network patients. They will work as a liaison between the practices, patients, and the Patient Financial Experience team to provide information and resources to prevent out-of-pocket cost for patients. Will work closely with management and PFE to stay up to date on insurance changes and processes.

The coordinator will be primarily accountable for:

• Demonstrate, support, and actively embrace the MGB/BWH mission, values and service guidelines in all interactions with all customers. Exhibit service-oriented behavior at all times with courtesy and compassion when interacting with patients.
• Use appropriate judgment in all interactions with customers and in carrying out all responsibilities. Demonstrate the ability to evaluate circumstances and make sound decisions.
• Participate actively in the work environment in a way that fosters communication, teamwork, cooperation, flexibility, respect, and diversity.
• Inform patients if BWPO and/or BWH is a nonparticipating provider with the patient's insurance carrier, provide them with outlined options and their financial responsibility, if applicable.
• Responsible for the daily management of the No Surprise Billing (NSB) EPIC workqueue, contacting patients who have been determined to have out of network insurance coverage.
• Works closely with participating practices to provide up to date information to the practice and patients.
• Facilitates communication with practices and providers to determine need for medical escalation and obtain out-of-network authorizations from the insurance companies.
• Act as a liaison between the department, the patients, hospital billing, and insurance companies.
• Responsible for utilizing resources and training material to stay informed and up-to-date on hospital and insurance changes.
• Maintains communication of outcomes by utilizing designated practice pools in EPIC inbasket messaging.
• Requires comprehensive knowledge of insurance eligibility and benefits as well as be able to navigate through payer policy and act as a champion for patient approvals when needed.
• Understand and adhere to PHS, BWH, and BWPO policies and procedures. Additionally, understand and adhere to all regulatory standards and laws including the Health Insurance Portability and Accountability Act (HIPAA) as they relate to job duties.

• Outreach:
• Outreach and follow-up with patients in between episodes of care as appropriate to promote a seamless and predictable healthcare experience
• Connecting with patients and insurance companies to bridge the gap of information in relation to insurance coverage and changes
• Perform all other duties as assigned

1. Bachelor's degree required.

2. 1-3 years of experience in a hospital setting and extensive knowledge of 3rd party payers and billing requirements, preferred.

3. Ease in interacting with patients, many of whom have complex injuries and multiple comorbidities, including social challenges.

4. Exceptional judgment and discretion in interacting with physicians and staff on sensitive political and confidential issues.

5. Knowledge of current issues in the healthcare environment preferred.

6. Familiarity with information systems preferred.

BWH is an Affirmative Action 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.