Job Details

Overview

Location: United States, Massachusetts, Burlington. Schedule: 40 hours per week; Monday through Friday from 9:30 AM to 6:00 PM. Location type: 100% remote.

Job Profile Summary

This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. It also covers Patient Access duties, including performing the administrative and financial-clearance tasks necessary to facilitate the procurement of clinical services. Responsibilities include collecting patients' demographic and financial information, scheduling services, and handling referrals to ensure patients are scheduled for recommended appointments and procedures. This is an entry-level role with routine work, typically performed under supervision.

Job Overview

Under the direction of the Pre-Services Revenue Cycle Leadership, the position supports Revenue Cycle workflows such as Front End Patient Support, Scheduling, Pre-Registration, Referrals and Authorization. The role works within Revenue Cycle and other service lines to support quality health care. Responsibilities include maintaining standard process discipline, developing a high-performance work team through training, coaching, mentoring and bi-monthly meetings, and achieving department KPIs/metrics. Responsibilities include inbound/outbound call support, pre-registrations, MyTuftsMed portal messages, Epic appointment workqueues, patient estimates, hospital orders transcription, referrals and authorizations, copay/deductible/coinsurance collections.

Job Description

Minimum Qualifications:

• Minimum High School Diploma or Equivalent

Preferred Qualifications:

• Experience in insurance, managed care, private physician's office practice or hospital registration setting
• Revenue Cycle, Patient Access or Pre-Services experience

Duties and Responsibilities

The duties and responsibilities listed below describe the general nature of work and are not all-inclusive. Other duties may be assigned.

1. Utilizes effective customer service etiquette and skills in all phases of telephone communications.
2. Obtains accurate demographic, financial and clinical information from patients/guarantors.
3. Understands and demonstrates knowledge of basic medical terminology.
4. Meets or exceeds patient handling, speed to answer, first contact resolution, hold time quality metrics within the context of customer satisfaction and minimal error rate.
5. Maintains a basic knowledge of billing, eligibility, referrals, pre-authorization, benefits, policy number requirements, and insurance order.
6. Possesses an understanding of instructions associated with various appointment types and procedures.
7. Responds to inquiries from patients, physicians and staff regarding registration, appointments, patient estimates, and provider messages.
8. Generates patient estimates and attempts to collect estimated amounts due prior to date of service; creates a hospital account note to support work.
9. Resolves caller inquiries and issues; transfers calls as needed following customer service guidelines.
10. Schedules, reschedules, and cancels appointments to maximize resource utilization.
11. Instructs patients in visit preparation with relevant information in a professional manner.
12. Utilizes information systems/tools such as Epic, Vyne/Trace, Microsoft Teams, and Amazon Connect/AWS.
13. Provides high level customer service when interfacing with patients, co-workers, referring physicians and internal/external customers.
14. Participates in achieving personal and departmental goals and initiatives.
15. Contributes to morale and teamwork; supports changes and communicates effectively.

Physical Requirements

• Frequent sitting, occasional standing and walking; intense mental workload with concurrent projects.
• Manual dexterity to operate a computer keyboard and related equipment.
• Requires ability to see computer screens, monitoring equipment and reports.

Skills & Abilities

1. Knowledge of Medical Terminology, CPT and ICD-10 codes.
2. Significant knowledge of Medicare, Medicaid, and third-party payer billing guidelines, compliance, and regulations.
3. Knowledge of Epic Cadence, Vyne/Trace, Microsoft Teams, Amazon Connect/AWS.
4. Analytical and critical-thinking skills with the ability to synthesize complex data sets.
5. Ability to interpret data and trends to implement recommendations for performance improvement.
6. Ability to collaborate across teams and align with Tufts Medicine's objectives.
7. Ability to build relationships with team members.
8. Strong oral, written and interpersonal communication skills.
9. Ability to work in a dynamic environment with frequent changes.
10. Excellent organizational skills and attention to detail.

Note: This posting excludes irrelevant boilerplate language. For more information, apply directly through the employer's website.