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Baystate Health Client Services Consultant in Springfield, Massachusetts

Summary:

The Client Services Consultant reports to the Manager, BMP Revenue Advisory Services and is accountable for supporting Baystate Medical Practices and the PBO Customer Services Unit by providing professional billing process triage, research, recommendations for problem resolution.

This position is critical to the BMP's operating excellence in professional billing. The incumbent, through in-depth knowledge of BMP billing policies, procedures and related systems, provides consultation that assures that billing operations are executed consistently and accurately across BH entities, including BMERF, BAPO and BVS. The incumbent provides prompt, customer-focused service through billing data analysis, telephonic and on-site support.

Job Responsibilities:

1) PBO contact for medical practices with billing process questions, including co-pay posting, TES edit resolution, batch close procedures, payments-on-account, write-off requests and instructions for completing reversals of referral and authorization denials.

2) On a weekly basis, prepares and communicates practice-specific billing reports to the BMP Financial Leadership Team and the administrative leadership of the medical practices. These reports quantify pending registration and coding edits and open cash batches. Independently identifies and follows-up with practice leadership on report trends that indicate billing process delays and/or concerns regarding compliance with billing operations standards, policies and procedures.

3) Provides research for and recommendations to the PBO Customer Services Unit to resolve patient billing disputes. Obtains and reviews data from the practices, frequently conducting invoice analysis and obtaining feedback from Compliance, Audit and Education.

4) Conducts on-site billing operations assessments for new practices, new locations and practices with new staff. Uses standardized assessment tool and exercise independent judgment regarding the strengths and weaknesses of the practice's billing operations. Documents the assessment for PBO and Practice Leadership and makes any necessary recommendations that would improve the practice's billing performance.

5) Provides on-site billing re-training for practice staff. Uses established lesson plans and handouts. Documents re-training for practice leadership and the Revenue Advisory Services' Training and Documentation Coordinator.

6) Obtains documentation and submits charge correction requests from practices and Compliance, Audit and Education.

7) On a monthly basis, remotely monitors all BMP cash batches at month-end close. Conducts timely outreach to billing staff and practice leadership to ensure a smooth transition by no later than 4:00 pm the day of close. If necessary, will remotely close batches on behalf of medical practices, retaining documentation for follow-up the next business day.

8) Upon request, participates in the evaluation of practice employee billing skills, including administration and scoring of a billing skills assessment tool and verbal feedback to Directors and Practice Managers.

9) Upon request and with specific direction about content, drafts practice correspondence and policies for review by the Manager of BMP Revenue Advisory Services.

Required Work Experience:

1) Upon request and with specific direction about content, drafts practice correspondence and policies for review by the Manager of BMP Revenue Advisory Services

Preferred Work Experience:

1) None Listed

Skills and Competencies:

1) Requires advanced IDX skills to to review, interpret and advise practices regarding TES edits and invoice corrections in IDX

2) Requires working knowledge of managing referrals and prior authorizations and their documentation in IDX and on billing tickets

3) Requires advanced written communication skills for correspondence with practice administrative leadership and staff

4) Requires demonstrated ability to collaborate with numerous departments across Baystate Health, including all medical practices, Compliance, Audit and Education, Treasury and IS to resolve complex billing questions such as disputed charges, unbalanced cash batches and duplicate and missing charges

5) Requires intermediate Word / Outlook skills

6) Requires basic Excel skills

7) Ability to exercise independent judgment during billing problem diagnosis and resolution

8) Ability to conduct basic data analysis, including running established reports, retrieving and presenting data in established Excel spreadsheets and interpreting a limited number of key billing process measures

9) Ability to meet high service standards, including timely and accurate responses to myriad billing inquires

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.

DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.

Education:

GED or HiSET (Required)

Certifications:

Equal Employment Opportunity Employer

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.

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