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Revenue Cycle Operations Specialist

2 months ago

Boston, Massachusetts, United States Tufts Medicine Full time
Job Summary

This role focuses on activities related to revenue cycle operations, including billing, collections, and payment processing. The Patient Placement Coordinator will perform administrative and financial-clearance duties necessary to facilitate the procurement of clinical services by patients.

Key Responsibilities
  • Conducts pre-registration tasks for specified inpatients and outpatients prior to their date of service, including collecting demographic, financial, and clinical information necessary for financial clearance.
  • Obtains consent for treatments and authorizations as necessary, and explains signature requirements to patients and their representatives in a manner that is easily understood.
  • Verifies the validity of insurance coverage via eligibility tools and ensures the appropriate plan codes have been added to registration based on the information provided.
  • Collects the appropriate information for auto and worker's compensation registrations, including information collected from the responsible party.
  • Notifies patients 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, and communicates these policies effectively to patients.
  • Posts collected payments in the system of record and verifies the 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 and documents patient's financial state and related information in the system of record.
  • Obtains authorization, pre-certification, referral, and/or notification as necessary, and attaches verification to patient's account and documents information in the system of record.
  • 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 and hospital financial information confidentially in accordance with all hospital policy and any state or federal regulations.
  • Meets the requirements of area-specific benchmarks related to productivity and customer service.