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: $64,350-$75,000

Position Summary

Columbia University Fertility Center seeks an outstanding Patient Financial Coordinator (PFC) to join the growing team in the NYC office. This is your opportunity to work in one of the top academic fertility centers in the U.S. You will work in an innovative, professional environment where your talent will contribute to changing patient's lives and have the chance to work with highly skilled Reproductive Endocrinology physicians, laboratory, and clinical staff.

This position acts as a crucial member of our patient care teams to coordinate the financial aspects of the patient's care while working with our other dedicated team members to create a positive and memorable patient experience. The PFC ensures that patients are well educated about the financial and insurance aspects of their care and that steps are taken by the practice to ensure that proper payment is 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, and they are accessible to patients for ongoing questions regarding this aspect of their care.

Responsibilities

Patient Financial Coordination

• 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, expected and actual fund usage throughout treatment to ensure understanding of coverage and upcoming out-of-pocket payment responsibilities.
  
  
  
  • Examples of medical criteria that needs to be met for patient to access IVF benefits; BCBS of NJ policy; if 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, in order for ICSI to be covered, partner must have 2 abnormal semen analysis (Morphology 3% or less and concentration must be less than 15 ml/million). Oxford, Aetna, UHC, & Emblem HIP does not allow banking, meaning patients cannot move forward with a second IVF cycle if patient has normal embryos from the first cycle.
  
  
  
  
• Ability to understand and interpret stimulation reports and can 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.

Third Party Reproduction

• Conduct intake for third party cases from assigned physician. Shadow Third party PFC on third party cases and assist with follow-up as directed. May provide cross-coverage on third party cases as needed.
• Proactively build knowledge of insurance policies and guidelines for third party reproductive care in order to be able to assist on these cases and provide cross-coverage.
• Facilitate transfer of donor cases to Senior Patient Financial Coordinator.

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.

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 in a constructive and respectful manner 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

• A minimum of 2 years of relevant experience.

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.

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, qualification, 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.

Equal Opportunity Employer / Disability / Veteran

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