Patient Service Representative I - Full-Time 2nd Shift

TuftsMedicine, Inc.; Lowell (MA); On-site; USD 57,653,000 - 72,065,000; Full time

Job summary

Tufts Medicine is seeking an on-site Patient Access Associate at Lowell General Hospital - Saints Campus Emergency Department. The role focuses on revenue cycle tasks, pre-registration, and insurance verification to facilitate timely clinical services. Training during first weeks may occur days/evenings/weekends as needed.

Strong customer service and data-entry skills are essential. The position emphasizes accurate data capture, financial clearance, and coordination with physicians and billing

Qualifications

• High school diploma or equivalent.
• 1 year of experience in customer service/hospital registration/insurance.
• Experience with EHR and medical terminology is preferred.

Responsibilities

• Perform pre-registration tasks for patients prior to service.
• Collect demographic, financial, and insurance information.
• Explain consent and authorization requirements clearly to patients.
• Post payments and manage patient financial information in the system.

Skills

Data entry

Excel familiarity

EHR knowledge

Customer service

Medical terminology

Education

High school diploma or equivalent

Job description

Hours:

40 hours per week; Monday, Tuesday, Thursday, Friday from 3:00-11:30 PM and every other weekend (Saturday and Sunday) from 2:30-11:00 PM

Location:

Onsite at Lowell General Hospital - Saints Campus Emergency Department

Requirements:

Availability to conduct day shift training Monday-Friday from 8:30 AM to 5:00 PM your first week. 2 additional weeks of onsite training are required and can be conducted during the day, evening, or weekends. 1 Winter and 1 Summer holiday are required to be worked at minimum.

Job Profile Summary

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. Collects patient's necessary demographic and financial information from physician offices, acute-care entities, or the patients themselves, schedules services for patients, and handles referrals from primary care doctors to ensure patients are scheduled for recommended appointments/procedures, etc. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a “hands on” environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An entry level role that typically requires little to no prior knowledge or experience, work is routine or follows standard procedures, work is closely supervised and communicates information that requires little explanation or interpretation.

Job Overview

This position is responsible for interviewing inpatients and outpatients with a courteous and professional demeanor to obtain accurate and complete patient registration data. Responsible for collecting and documenting in hospital registration system demographic and financial information for scheduled visits and completing pre-service collection of patient liability (including, but not limited to deductibles, coinsurances, co-payments, etc.) and/or bad debt.

This position is also responsible for verifying patient insurance, confirming benefits eligibility, performing pre-authorization, pre-certification, and/or notification as required by third party providers.

Job Description

Minimum Qualifications

• High school diploma or equivalent.

Preferred Qualifications

• One (1) year of experience in customer service setting, hospital registration, medical office, insurance, etc.

Duties and Responsibilities

• 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; obtains missing insurance information via patient’s family or physician offices; and completes insurance verification using online electronic verification system or contacting payor directly.
• 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.
• Verifies the validity of insurance coverage via eligibility tools. Ensures the appropriate plan codes have been added to registration based on the information provided in the eligibility response. Educated on different insurance plans and coordination of benefits. Able to identify if there are any concerns with coverage after checking insurance eligibility.
• 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. If full information is not collected, notes are properly documented as to why the information was not collected or available.
• Notifies patient of financial liabilities as determined by insurance benefits, coverage limits, and appointment/procedure-specific charges.
• Takes an active role in the collection of patient payments. Understands all collection policies and procedures that pertain to time-of-service collections. Communicates these policies effectively to patients following prescribed scripting. Understands the use of credit card devices regarding payments and credits. Is aware of all types of credit cards accepted by the organization.
• Posts collected payments in system of record and verify appropriate dollar amount and volume are posted in compliance with department guidelines.
• Provides Financial Counselor contact information to patients qualifying for state-sponsored financial assistance. Documents patient’s financial state and related information in system of record for reference of hospital administration and billing.
• Obtains authorization, pre-certification, referral, and/or notification as necessary. Attaches verification to patient’s account and documents information in the system of record for reference of hospital administration and billing.
• Takes personal responsibility to provide excellent customer service and delivers exceptional professional courtesy to all patients.
• Interacts with physicians, nursing units, and office staff in a courteous and professional manner.
• Maintains hospital financial information confidentially in accordance with all hospital policy and any state or federal regulations such as the HIPAA Privacy & Security Standards.
• 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.

Physical Requirements

• Frequent sitting, standing and walking while working, and lifting 10-15 pounds.
• Must be able to reach supply shelves in the office or supply room and reach printers and copiers.
• May be exposed to dust and other typical office-like discomforts.
• Manual dexterity using fine hand manipulations for computer keyboard operation.
• Requires ability to see computer screen and read reports.
• Requires ability to hear communications from coworkers, and from physicians and/or other clinical staff

Skills & Abilities

• 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.
• Strong customer service skills including excellent interpersonal and telephone skills.
• High degree of tact is necessary due to frequent interaction with patients, physicians, and insurance companies.
• Experience using computer-based, patient registration systems.
• Thorough understanding of private insurance, Medicare, and Medicaid programs.
• Knowledge of medical terminology.
• 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. The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals. Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth—one of the many ways we invest in you so you can thrive both at work and outside of it. Pay Range: $20.12 - $25.15 based on full-time equivalent

Tufts Medicine is a leading integrated health system bringing together the best of academic and community health care to deliver exceptional, connected and accessible care experiences to consumers across Massachusetts. Comprised of Tufts Medical Center, Lowell General Hospital, MelroseWakefield Healthcare, an expansive home care network and a large clinically integrated physician network, Tufts Medicine has more than 15,000 dedicated employees and caregivers. The health system came together in 2014 to leverage the experience of its member organizations and integrate their missions to together transform the ways that consumers engage with and experience their care.