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Tufts Medicine·Boston, MA

Patient Service Representative I - Full-Time, Day Shift

Full timeMon–Fri · Days
✓Requirements
Certifications
Obtains authorization, pre-certification, referral, and/or notification as necessary. preferred
Education
✓1.High school diploma or equivalent.
✓High degree of tact is necessary due to frequent interaction with patients, physicians, and insurance companies.
Qualifications
✓2. Obtains consent for treatments and authorizations as necessary. Explains signature requirements to patients and patient’s representatives in a manner that is easily understood by the patient or their representative.
✓13. Meets the requirements of area specific benchmarks related to productivity and customer service such as wait times, call monitoring score card scores, number of registrations or calls processed, etc.
✓Computer literacy required including familiarity with word documents, Excel spreadsheets, email applications and be able to learn new applications, including the Organization’s Electronic Health Record (EHR). Ability to perform accurate data entry.
✓2. Strong customer service skills including excellent interpersonal and telephone skills.
✓3.
✓4. Experience using computer-based, patient registration systems.
✓5. Thorough understanding of private insurance, Medicare, and Medicaid programs.
✓6. Knowledge of medical terminology.
✓7. Excellent organizational skills required with attention to detail. Ability to prioritize work and be flexible with work assignments.
✓At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day.
1.One (1) year of experience in customer service setting, hospital registration, medical office, insurance, etc. preferred
Duties and Responsibilities : The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned. preferred
Conducts Pre-Registration tasks for specified inpatients and outpatients prior to their date of service including: collects demographic, financial, and clinical information necessary for financial clearance of scheduled patients preferred
obtains missing insurance information via patient’s family or physician offices preferred
and completes insurance verification using online electronic verification system or contacting payor directly. preferred
Verifies the validity of insurance coverage via eligibility tools. preferred
Ensures the appropriate plan codes have been added to registration based on the information provided in the eligibility response. preferred
Educated on different insurance plans and coordination of benefits. preferred
Able to identify if there are any concerns with coverage after checking insurance eligibility. preferred
Collects the appropriate information for auto and worker’s compensation registrations including information collected from the responsible party including the auto or worker’s compensation carrier, agent and/or employer. preferred
If full information is not collected, notes are properly documented as to why the information was not collected or available. preferred
5. Notifies patient of financial liabilities as determined by insurance benefits, coverage limits, and appointment/procedure-specific charges. preferred
Pay for this position
Employer-posted
$20.12 – $25.15/hr
Apply to Tufts Medicine ↗
Questions about pay or the unit? Ask a Waypoint recruiter.
✓You’ll need
Certifications
Obtains authorization, pre-certification, referral, and/or notification as necessary. preferred
Education
✓1.High school diploma or equivalent.
✓High degree of tact is necessary due to frequent interaction with patients, physicians, and insurance companies.
Qualifications
✓2. Obtains consent for treatments and authorizations as necessary. Explains signature requirements to patients and patient’s representatives in a manner that is easily understood by the patient or their representative.
✓13. Meets the requirements of area specific benchmarks related to productivity and customer service such as wait times, call monitoring score card scores, number of registrations or calls processed, etc.
✓Computer literacy required including familiarity with word documents, Excel spreadsheets, email applications and be able to learn new applications, including the Organization’s Electronic Health Record (EHR). Ability to perform accurate data entry.
✓2. Strong customer service skills including excellent interpersonal and telephone skills.
✓3.
✓4. Experience using computer-based, patient registration systems.
✓5. Thorough understanding of private insurance, Medicare, and Medicaid programs.
✓6. Knowledge of medical terminology.
✓7. Excellent organizational skills required with attention to detail. Ability to prioritize work and be flexible with work assignments.
✓At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day.
1.One (1) year of experience in customer service setting, hospital registration, medical office, insurance, etc. preferred
Duties and Responsibilities : The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned. preferred
Conducts Pre-Registration tasks for specified inpatients and outpatients prior to their date of service including: collects demographic, financial, and clinical information necessary for financial clearance of scheduled patients preferred
obtains missing insurance information via patient’s family or physician offices preferred
and completes insurance verification using online electronic verification system or contacting payor directly. preferred
Verifies the validity of insurance coverage via eligibility tools. preferred
Ensures the appropriate plan codes have been added to registration based on the information provided in the eligibility response. preferred
Educated on different insurance plans and coordination of benefits. preferred
Able to identify if there are any concerns with coverage after checking insurance eligibility. preferred
Collects the appropriate information for auto and worker’s compensation registrations including information collected from the responsible party including the auto or worker’s compensation carrier, agent and/or employer. preferred
If full information is not collected, notes are properly documented as to why the information was not collected or available. preferred
5. Notifies patient of financial liabilities as determined by insurance benefits, coverage limits, and appointment/procedure-specific charges. preferred
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About the role

​This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Patient Access duties: Performs the administrative and financial-clearance duties necessary to facilitate the procurement of clinical services by patients.