Nemours is seeking an International Medicine Account Coordinator to join our team in Orlando, FL. This position is responsible for coordinating financial accounts and securing payment by parties responsible for international patients receiving care at NCH-FL and coverage for Nemours enterprise sites , including but not limited to: development of cost estimates, ensuring collection prior to care when appropriate, managing insurance claims, insurance verification, development of unique processes to ensure smooth work flow and communication, maintaining relationships with a variety of payer types, billing coordination, collections, and denial management. Some travel is required.

Financial Clearances:

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  Develops detailed cost estimates, including professional and hospital service fees, for each patient treated at NCH-FL and affiliated Nemours treatment sites .
• Works closely with Care Coordination and Finance teams to collect detailed information on treatment plans for each patient.
• Meets with families to review Nemours' financial processes related to care.
• Works with families to collect estimated care costs prior to patient's initial appointment; ensures all payments are received and receipted as agreed upon.
• Develops care cost estimates for international insurance sponsors and collects required financial authorizations prior to patient's initial appointment.
• Follows up with patients and sponsors in the event of unplanned treatments or complication requiring additional payment.
• Utilizes electronic medical records to develop in-depth financial plan estimates for team and family, developing comparisons between prior patients and propose patient.
• Verifies patient insurance coverage and obtains required authorization.

International Sponsor Financial Clearance:

• Works closely with international insurers and carriers to verify patient's coverage, determines, and collects appropriate out-of-pocket payments prior to services being rendered.
• Provides prior estimates to international insurers and carriers as requested.
• Keeps international insurers and carriers updated on charges for patients receiving treatment at NCH-FL and affiliated sites, and on any complications requiring additional approval.
• Works closely with foreign embassies and government agencies to obtain Letters of Authorization for sponsored patients receiving treatment at NCH-FL and affiliated sites.
• Works closely with embassies and government agencies to obtain approval and extensions of existing Letters of Authorization for patients who are extending their treatment and stay.
• Follows up with international payers (insurance, embassies, governments) to collect payment in a timely fashion.

Data Collection and Reporting

• Provides reports on a monthly/quarterly basis or as required regarding incoming patients, completed patients, total charges, payments, and balances.

Audit and Reconciliation

• Regularly reconciles posted charges and payments in the system to match program's records.
• Regularly audits international patient's financial designation, address, and other specific data elements.

Additional Responsibilities:

• Responds to inquiries within 24 business hours.
• Assists families in troubleshooting and problem solving during their stay with Nemours.
• Follows up with patients and sponsors in cases involving unplanned treatments or complications which might require additional payment.
• Escalates all requests for pro-bono treatment to program and hospital leadership.
• Attends family and care team meetings as requested.

Job Requirements

• Associate degree preferred/ Bilingual preferred.
• 3-5 years of related experience required.
• Intermediate medical coding, billing, and or medical insurance experience required.
• Coding, billing certification preferred.