Job Profile Summary
This role focuses on performing activities associated with evaluating, developing, recommending, implementing, and carrying out the policies and procedures related to the delivery of high quality patient care. In addition, this role focuses on performing the following Customer Service duties: Guides the patient through the healthcare system and works to overcome obstacles that are in the way of the patient receiving the care and treatment they require. 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. A senior level role that requires broad knowledge of operational procedures and tools obtained through extensive work experience and may require vocational or technical education. Works under limited supervision for routine situations, provides assistance and training to lower level employees, and problems typically are not routine and require analysis to understand.
Job Overview
The position supports scheduling and pre-registration for Tufts Medicine. The position works cooperatively within the department and with other service lines throughout Tufts Medicine to create a system of quality health care. Responsible for assuring that standard process discipline is adhered to. Ensures a high-performance work team is developed through training, coaching, mentoring and bi-monthly meetings. Responsible for supporting both inbound and outbound phone ques, patient registrations, online appointment web request, MyTuftsMed Messaging, appointment work ques, patient estimates, receiving and transcribing provider orders, collections of copays, deductible and/or co insurances.
Job Description
Minimum Qualifications:
1. High School Diploma or equivalent
2. Two (2) years’ experience in insurance, managed care, private physician’s office practice or hospital registration setting
Preferred Qualifications:
1. Knowledge of Epic, Epic Cadence
2. Progressive Access Center/Patient Access or Pre-Services experience: Health insurance Benefits, Financial Clearance, Customer Service/Patient Experience.
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.
1. Utilizes effective customer service etiquette and skills in all phases of telephone communication.
2. Obtains accurate demographic, financial and clinical information from patients.
3. Understands and demonstrates knowledge of basic medical terminology and diagnostic procedures.
4. Meets or exceeds patient handling, speed to answer, first patient resolution and hold time quality metrics within the context of excellent customer satisfaction and minimal error rate.
5. Maintains a basic knowledge of third-party billing: understands eligibility, referrals, pre-authorization, broad scope of benefits, policy number requirements, subscriber vs. guarantor, and order of insurance.
6. Possess a solid understanding regarding specific instructions associated with various types of appointments, procedures and providers.
7. Triages and responds to telephone or electronic inquiries from patients, physicians, employees and other customers regarding registration, appointments, prescription refills, provider messages and other services.
8. Works to resolve all caller inquiries and issues and demonstrates ability to transfer calls by following customer service guidelines.
9. Accurately and promptly schedules, reschedules and cancels appointments to maximize resource utilization of providers for optimum efficiency.
10. Instructs patients in preparation of visit by providing any preparation, location and other general information in a professional and courteous manner.
11. Utilizes information systems/tools, such as Epic, OnBase, Microsoft Teams, Amazon Connect/AWS.
12. Reads email periodically throughout the day and reviews other written sources to keep up to date on all communication/changes within the organization.
13. Consistently provides the highest level of customer service when interfacing with patients, co-workers, referring physicians and other Tufts MC departments.
14. Exhibits a willingness to solve problems constructively and seeks excellence in the performance of job.
15. Participates in the achievement of personal and departmental goals and initiatives.
Physical Requirements:
1. Work environment: professional office environment with typical office requirements such as computers, phones, photocopiers, filing cabinets, etc.
2. This is largely a sedentary role, which involves sitting most of the time, but may involve movements such as walking, standing, reaching, ascending / descending stairs and operate office equipment
3. Frequently required to speak, hear, communicate and exchange information
4. Able to see and read computers displays, read fine print, and/or normal type size print and distinguish letters, numbers and symbols
5. Occasionally lift and/or move up to 25 pounds
6. Ability to work in confined or open environments
7. Ability to work independently or in a team environment
8. Requires manual dexterity using fine hand manipulation to operate a computer keyboard or related equipment
9. Requires ability to see computer screen, monitoring equipment and reports.
Skills & Abilities:
1. Significant knowledge of Medicare, Medicaid, and third-party payer billing, rules, guidelines, compliance, and regulations
2. Actively contributes to positive morale and teamwork; stays informed and supports changes and initiatives, demonstrates good communication skills.
3. Strong oral, written and interpersonal communication skills.
4. Ability to work in a complex environment with frequent changes.
5. Excellent organizational skills required with attention to detail.
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