GENERAL SUMMARY/ OVERVIEW STATEMENT:

Brigham and Women's Hospital is committed to putting every patient first. Every employee plays a role in providing a positive impact on patients and the care they receive at Brigham Health. Our service will be distinguished by the delivery of high-quality and safe patient care, respect and dignity in all interactions with patients, families and colleagues and by customer service excellence.

Brigham Health Primary Care is committed to racial justice by building and active enforcement of policies, practices, attitudes, and actions that produce equitable access, treatment, and outcomes for all people. Our clinics are grounded in team-based, patient and family-centered care. We partner with communities to seek health and wellness, working to eliminate health care inequities with an expanded care team that includes behavioral health, social workers, nurses, population health coordinators, patient navigators, community health workers, community resource specialists, high-risk RN case management, and support for virtual visits.

All employees are expected to embrace this commitment and demonstrate behavioral competencies in the following areas:

People: Focus on serving the community through collaboration and respect

Self-Management: Accountability, professionalism and commitment to growth and development

Organization: A commitment to quality, service and exceptional performance

Meeting these expectations is key to the success of the department and the organization.

This job description includes:

* General expectations for the position

* Addendum A - BWH Behavioral Competencies

* Addendum B - Job Specific Tasks and Responsibilities

* Addendum C - Physical/Working Conditions

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Actual job duties may vary by department (see Addendum B for more detail)

* Perform duties under moderate supervision with intermediate to advanced proficiency in administrative skills.

* Act as a super user for scheduling, registration, and billing systems. Provide training and assistance to others in these areas.

* May perform more complex or specialized functions (i.e. surgical scheduling) at highest competency level.

* Utilize knowledge of HMO's, managed care and other third-party insurers, and troubleshoot insurance issues as appropriate.

* Assist with training and orienting staff as needed.

* Provide cross coverage as needed.

* Assist with special projects as directed.

* Follow HIPAA guidelines for the management of patient privacy and confidentiality.

* Other duties, as assigned.

JOB SPECIFIC DUTIES AND RESPONSIBILITIES:

* Provide each BH Primary Care, Medicaid ACO patient with the highest level of customer service, in a manner that is culturally sensitive and non-judgmental.

* Represent BH Primary Care by serving as the primary point of contact, through telephonic and electronic communication, for patients who are due for recommended care and/or have unaddressed acute care needs.

* Partner with practice-based social services and available community resource specialists to manage our patient population by making outreach calls to current patients to engage them in care.

* Work collaboratively with each patient to help him/her/them select an appointment that best matches his/her/their preference, and schedule that patient with the appropriate provider and timeframe.

* Partner with practice-based nursing to appropriately triage any patients' acute care needs.

* Identify barriers to attending medical appointments and resources such as transportation, to address these services when necessary.

* Supports patients' ability to utilize Patient Gateway to access medical records and virtual visits, as needed.

* Act as a liaison between patients, hospital billing department, hospital registration department, and BH Primary Care practices in addressing insurance related inquiries and issues.

* Document patient outreach and planning appropriately in the patients' record.

* Answer questions about BH Primary Care, as needed, or understand resources to refer patients to.

* Carry out periodic check-ins with BWH Primary Care Administration to update on the status of Medicaid ACO patient-related activities.

* Maintain the highest level of communication to foster productive and collaborative relationships with Practice Managers, Practice Coordinators, and/or Practice Assistants at each of our Primary Care Practices (currently 14 in number).

* Continuously work to improve both the functioning of this position and the customer experience (with our primary customers being our current patients and members of our BH Primary Care practices).

* Perform all other duties as assigned.

QUALIFICATIONS:

Level of education required:

* Minimum of a high school diploma or GED required.

Work experience required:

* Minimum one year applicable work experience required.

* Some additional training in office systems or other post high school education preferred.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

Technical skills required:

* Knowledge of practice operations and standards.

* Understanding of procedures including filing, copying, scanning, printing, and faxing.

* Phone skills: Ability to use phone system (answer and screen calls, put on hold), handle more complex calls and give more detailed information.

* Verbal skills: Ability to interpret information as appropriate, answer more complex questions in the most professional manner and communicate in a professional, courteous, clear and concise manner.

* Organization Skills: Ability to manage work processes in a neat and orderly way and to sort and alphabetize. Ability to manage multiple tasks effectively, follow established protocols, and work within systems.

* Writing Skills: Ability to correspond and communicate with others clearly and effectively in writing (via e-mail, memo or interoffice note) and to take complete and accurate messages.

* System Skills: Ability to type accurately and enter data at an intermediate level. Advanced computer skills. Ability to use all applicable applications at highest competency level.

* Understanding of the appropriate use and importance of related forms.

* Intermediate understanding and use of medical terminology.

* Intermediate comprehension of insurance types and referral process.

* Intermediate comprehension of registration and fiscal information.

* Knowledgeable and compliant with all hospital, State and Federal requirements (where applicable to job performance), including policy and procedures with The Joint Commission and HIPAA.

Behavioral competencies required:

* See Addendum A

JOB SPECIFIC SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

* Excellent interpersonal skills

* Excellent customer service skills and ability to always put the patient first

* Proficiency in oral/interpersonal and written communication

* Highly organized, proactive and attentive to details

* Ability to work independently, under minimal supervision

* Ability to work as a member of a collaborative, multidisciplinary team

* Strong ability to recognize problems, think creatively, and devise innovative solutions

* Flexible, sensitive, and ability to adapt to changes in patients' needs and/or their willingness to participate in their health care

* Knowledge of medical terminology, preferred

* Computer Literacy/Data Entry Skills, with proficiency in Microsoft Office Suite, e.g. Excel, Office, SharePoint, Teams

* Spanish language fluency a plus, but not required

RSRMGB