Patient Service Representative I - Full-Time, Weekdays

Summary: Tufts Medicine is a healthcare organization seeking a Patient Service Representative I to support revenue cycle operations and patient access duties. This role involves collecting patient information, verifying insurance, and ensuring a smooth registration process for patients. The position requires strong customer service skills and the ability to work under supervision in a fast-paced environment. 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 Required Qualifications: - High school diploma or equivalent - 3 weeks of fulltime dayshift training are required - Strong customer service skills including excellent interpersonal and telephone skills - Ability to perform accurate data entry - 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) - 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 Preferred Qualifications: - One (1) year of experience in customer service setting, hospital registration, medical office, insurance, etc - Experience using computer-based, patient registration systems Required Skills: Patient Registration, Insurance Verification, Pre-authorization, Pre-certification, Referral Management, Electronic Health Record (EHR), Data Entry, Customer Service, Medical Terminology, Private Insurance, Medicare, Medicaid, Use of Patient Registration Systems, Computer Literacy - Word, Excel, Email, Telephone Skills, Tact Benefits: Comprehensive Total Rewards package, Supports your health, financial security, and career growth