Financial Case Coordinator (HS)

The Ohio State University

12d•Onsite

About The Position

The Comprehensive Weight Management and Bariatric Surgery Program at The Ohio State University Wexner Medical Center is committed to providing the community/region it serves with high quality surgical and non-surgical weight management care. This position reports to the Program Manager and Program Director and functions as an integral member of team, overseeing patients referred for bariatric surgery in regards to insurance verification and authorization, benefit determinations and assisting patients with the understanding their benefit and program requirements. This position will also work in concert with the Department regarding planning needs to support bariatric surgery initiatives as well as revenue cycle support. The hours of operation are Monday - Friday, 7:30am - 4:30pm, with occasional evening information sessions. Oversees a variety of processes related to hospital intake primarily of bariatric patients, ensuring that all necessary communication and follow through occurs to accommodate smooth, patient-oriented access to services. Serves as primary contact for bariatric patients with regards to insurance verification, benefit plans and financial screening. Works with insurance payers to verify and begin pre-determination process and submits necessary documentation to payers in order to verify policy plan coverage specific to bariatric coverage. Maintains database and internal/external documentation for all bariatric patients referred for pre-determination. Mains regular communication and coordination with the all CWM staff, physicians, hospital departments of Inpatient and Outpatient Scheduling, Registration, Managed Care Contracting, Financial Counseling and Customer Service, and Health System departments of Admitting, Insurance Pre-certification and Patient Accounting. Oversees and facilitates upfront communication and interaction regarding insurance coverage with potential bariatric candidates as needed. Maintains familiarity with all aspects of the patient intake process to facilitate early detection of problems. Evaluates processes on an ongoing basis to address gaps in patient communication and access. Develops, recommends and implements action plans to improve processes. Maintains familiarity with state and federal legislation/laws regarding coverage of medical services as related to bariatric and communicates/verifies this information to insurance payers as needed.

Requirements

Bachelor's degree or equivalent combination of education and experience.
Extensive experience in health access program planning, organization and administration required.
Knowledge of and/or experience with bariatric benefits, quality improvement, cost reduction, current registration & billing policy and procedures as well as scheduling policies and procedures strongly desired.
Experience with insurance verification strongly desired.
Experience in a healthcare setting or physician?s practice preferred.
Experience utilizing Microsoft Office software applications, EPIC/IHIS, as well as multiple databases and software applications desired.
Experience using automated databases for management and reporting desired.

Responsibilities

Overseeing patients referred for bariatric surgery in regards to insurance verification and authorization, benefit determinations and assisting patients with the understanding their benefit and program requirements.
Working in concert with the Department regarding planning needs to support bariatric surgery initiatives as well as revenue cycle support.
Overseeing a variety of processes related to hospital intake primarily of bariatric patients, ensuring that all necessary communication and follow through occurs to accommodate smooth, patient-oriented access to services.
Serving as primary contact for bariatric patients with regards to insurance verification, benefit plans and financial screening.
Working with insurance payers to verify and begin pre-determination process and submits necessary documentation to payers in order to verify policy plan coverage specific to bariatric coverage.
Maintaining database and internal/external documentation for all bariatric patients referred for pre-determination.
Maintaining regular communication and coordination with all CWM staff, physicians, hospital departments of Inpatient and Outpatient Scheduling, Registration, Managed Care Contracting, Financial Counseling and Customer Service, and Health System departments of Admitting, Insurance Pre-certification and Patient Accounting.
Overseeing and facilitating upfront communication and interaction regarding insurance coverage with potential bariatric candidates as needed.
Maintaining familiarity with all aspects of the patient intake process to facilitate early detection of problems.
Evaluating processes on an ongoing basis to address gaps in patient communication and access.
Developing, recommending and implementing action plans to improve processes.
Maintaining familiarity with state and federal legislation/laws regarding coverage of medical services as related to bariatric and communicating/verifying this information to insurance payers as needed.