• Employment Type: Full Time
• Shift: Days
• Hours: 8am-4:30pm
• Location: Boston, MA

Reporting to the Supervisor/Manager of Patient Financial Services, performs designated functions of the patient service support process and self-pay accounts receivable. Provides excellent customer service to our patients to promote a positive experience.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Answers billing office main line and assists patients, practices and insurance reps with billing issues. Answers telephone inquiries and incoming correspondence regarding attorney inquiries for automobile accident, lawsuits, bankruptcy, and estates; and status of the account and assists with resolution.
• Obtains Self-Pay and Customer Service mail from the Production Department and sorts and distributes between areas, collectors, and representatives in accordance with account assignments. Keeps a daily log of the number and types of mail each Collector/Representative receives and processes.
• Verifies third-party coverage, makes appropriate financial class changes, and bills account to the third-party carrier. Responsible for maintaining a tickler system for the follow-up and monitoring of assigned accounts.
• Receives Trial Balances, reports, etc. from Production Department and distributes on a weekly basis. Receives monthly financial reports to help expedite and resolve account issues.
• Maintains a log of number of patients, total dollar amounts reflected, and collector/representative assigned for reports and documentation distributed. Maintains statistical database on number and dollar amount of accounts worked by collector/representative and number and dollar amount of payments received.
• Researches adjustment and/or write-offs.
• Proactively works on Self Pay aging receivables in attempt to collect payment or responsible payor information for processing.
• Logs, distributes, handles, monitors, and tracks all daily requests made by collectors/ representatives for information obtained from other departments, such as charge batches, cash batches, refunds, transfers, billing error credits.
• Maintains Charity/Free Care billing process and reports, and reviews financial questionnaires for Charity/Free Car consideration.
• Reports deviations of receipt time frames to Team Leaders and Supervisor.
• Requests, receives, and attaches appropriate billing/collection documentation to claims requested by the Patient Services and Self-Pay Collections work units.
• Researches return and bad address mail in the Hospital and Pratt systems. Updates system as appropriate. Uses criss-cross directory, Hospital computer system, property books, etc. to research and obtain correct addresses on returned mail.
• Logs and handles Medical Record Information Requests, Attorney Requests and Third Party Carrier requests for information.
• Verifies questionable third party payments in an attempt to satisfy the patients concerns and to obtain payment for the remaining balance on the account.
• Provides complete and accurate data (such as, itemized bills, medical records, etc.) to patients, guarantors, attorneys, etc. after receipt of appropriate release authorization documentation.
• Prepares write-offs for accounts of homeless and shelter patients.
• Prepares bad address accounts for bad debt write-off and referral.
• Works with Collection agencies with information needed on bad debt accounts.
• Performs on-line data entry of account changes, and documents on the system all conversations and follow-up actions taken to resolve outstanding accounts. On accounts that cannot be appropriately resolved, notifies the Team Leader.
• Makes appropriate financial class changes.
• Files daily work in accordance with departmental policy and procedure.
• Maintains problem resolution folder and log. Reviews on a daily basis and notifies Supervisor of unresolved issues and discrepancies.
• Assists Team Leader with edit error corrections.
• Collects and inputs statistical data for department productivity and collection logs.
• Identifies opportunities to improve the patient customer service process.
• Performs duties and job functions in accordance with the policies and procedures established for the Department, and meets established short and long-term goals and objectives.
• Remains knowledgeable and current on consumer credit, third-party billing, follow-up and collection applications, requirements, and regulatory guidelines at the federal, state, and local levels for assigned accounts/financial classes.
• Completes daily productivity reports; meets departmental productivity standards; and complies with quality improvement and feedback initiatives as designated by management.
• Where appropriate, attends and actively participates in inter/intra-departmental/organizational meetings.
• Works closely with team members to increase effectiveness and efficiency of overall Department functions.
• Meets all monthly and year-end fiscal closing deadlines as they relate to the patient customer service process. Reports charge entry trends and issues to Team Leader. Works closely with team members to maintain and monitor the integrity of the patient customer service and the billing and collection process.
• Provides back-up coverage for other team members in case of absence. Retrieves files/records as needed or requested. Performs other duties and assignments as requested by management.

JOB KNOWLEDGE AND SKILLS:

A basic knowledge of the application of consumer credit, self-pay collections, and other third party payer rules, regulations, guidelines, and requirements for billing, collection, and reimbursement appeals. A basic understanding of how these regulations are applied to Massachusetts providers is desirable.

• Exceptional organizational skills.
• Ability to learn PC based computer systems, word processing, database and spreadsheet software programs.
• Ability to use a calculator, Blue Shield, Medicare, Medicaid and other third-party computer/electronic application systems efficiently and effectively.
• Excellent interpersonal skills, with ability to deal effectively with upset or difficult patients.
• Excellent communication skills and the ability to effectively communicate with all levels of staff.
• Ability to work independently and as part of a team in a fast paced environment that can be highly stressful.
• Completion of a medical terminology course and understanding of CPT and ICD diagnosis coding preferred.
• Familiarity with medical terminology, CPT and ICD diagnosis coding desired.
• Billing, accounts receivable, and /or paperless collection software knowledge desired. SMS and/or IDX billing, NEHEN eligibility system and/or paperless collection system experience preferred.
• Ability to systematically arrange workload and complete tasks within specified time frames.

EDUCATION:

• A college, vocational, or technical degree in a related field is preferred. A high school diploma or GED completion is required.

EXPERIENCE:

• Minimum of two years experience in an automated medical billing and collection environment for a medical services provider and/or third party payer, preferably in a large volume physician/hospital practice.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Normal Office Environment

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.