Case Rate Coordinator

Overview

Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, Fred Hutch is the only National Cancer Institute-designated cancer center in Washington.

With a track record of global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines, Fred Hutch has earned a reputation as one of the world’s leading cancer, infectious disease and biomedical research centers. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services, and network affiliations with hospitals in five states.

Together, our fully integrated research and clinical care teams seek to discover new cures to the world’s deadliest diseases and make life beyond cancer a reality.

At Fred Hutch we value collaboration, compassion, determination, excellence, innovation, integrity and respect. Our mission is directly tied to the humanity, dignity and inherent value of each employee, patient, community member and supporter. Our commitment to learning across our differences and similarities make us stronger. We seek employees who bring different and innovative ways of seeing the world and solving problems.

The Case Rate Coordinator works directly with partner organizations and Case Rate Insurance vendors to assure that payments are received accurately and timely. Prepares payments to disburse to partner organizations and outside providers.

Answers case rate related questions. Identifies and provides patient information for Accounting department to process correctly for General Ledger.

• Maintain knowledge and understanding of Case Rate Contracts and IMTX Single Case Agreements with bundle language.
• Manage case coverages and Transplant Billing Terms in Epic Bundle Episodes for case rate patient population.
• Maintain open communication with inner-departmental staff including Intake, Financial Clearance, and Transplant Transition RN’s.
• Notify partners of active cases and work with partners, including answering questions throughout case to closure.
• Coordinate case period claims from all partners with balances to bill.
• Manage Patient and claims information in Access Data Base.
• Validate bundle package and create Invoice.
• Submit Case Rate Bundles for claims processing either electronically or via Fed Ex.
• Monitor cases and work with payers resolving any claims issues or payment disputes until payment is received.
• Reconcile accounts and ensure all claims have been paid according to contract.
• Distribute funds to Fred Hutch Accounts and to partners for their claims included in Case Rate billing.
• Refund any case payment related over-payments to responsible payers.
• Manage BCHP monthly billing and work with King County until payment is received.

Required:

• High school graduate or equivalent
• Minimum one year of experience with Medical Billing and payment or or equivalent coursework. Minimum one year of experience with payment reconciliation related work or equivalent coursework. Minimum one year of customer service related experience, including payer relations, inter-departmental, and partner communications.
• Ability to use a computer keyboard and mouse, navigate computer programs, and use email in a business setting.
• Ability to communicate verbally in person, on the phone, and in writing in a clear and concise manner.
• Strong working knowledge experience with Micro Soft Office Suite, including Outlook, Excel, Access Database.
• Attention to detail and ability to analyze large sets of number related data.
• Identify and make recommendations regarding system issues.
• Ability to understand and meet performance standards.

Preferred:

• Understanding of billing edits and ability to resolve/or make recommendations.
• Working knowledge of Case Rate and what it means when involving billing.
• Understanding of billing edits and ability to resolve/or make recommendations to resolve any billing related issues.
• Experience using Epic HB and Prelude Registration.
  
  Experience in Revenue Cycle working with contract related billing.

The…