Job Description

Under general supervision of the Financial Coordination Supervisor, screens all Tufts MC patients who are uninsured or underinsured for benefits. The Financial Coordinator is responsible for securing insurance or a source of payment for all elective services performed at Tufts MC before the date of service and making sure all patients who are urgently admitted are screened for coverage in a timely manner. The Financial Coordinator is a resource for Tufts Medical Center to assist patients with any insurance-related question or refer patients to the appropriate department within the hospital.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• The Financial Coordinator is responsible for assisting all patients with any billing and financial issue related to a hospital admission, ED visit or outpatient services for both the hospital and the physician billing services. The Financial Coordinator must manage a daily worklist along with walk-in patients and phone calls and meet weekly productivity standards. The Financial Coordinator acts as point person for the patient for all billing and financial questions regarding the admission, prior to, during, and after the hospital stay.
• They obtain all insurance information within an appropriate time frame prior to the date of service to ensure proper authorizations and or referrals can be obtained from insurance payers. The Financial Coordinator is responsible for providing this information to the PreCertification or Referral Management team at Tufts Medical Center so the services can be approved for the patient. If a patient is uninsured or underinsured, the Financial Coordinator will screen and submit all applications for Massachusetts state programs including MassHealth, ConnectorCare and the Health Safety Net. They also will assist patient with completing disability supplements, if needed. They must follow the application until a determination has been made and assist the patient enrolling in a MCO or ACO, if applicable. The Financial Coordinator may refer patients to outside vendors and agencies or assist patients directly with out-of-state Medicaid applications and SSI or SSDI benefits.
• The Financial Coordinator works closely with the Clinical Case Managers, Social Workers, Physicians and other staff members of Tufts MC to ensure the patient is on the highest level of benefits available to them based on eligibility criteria. Effectively communicates with clinical team to ensure insurance issues do not cause delays in discharge.
• The Financial Coordinator resolves all self-pay liabilities for both the Hospital and Physicians Organization prior to the date of service. Resolution may mean collection of cash, establishment of payment plans, eligibility for numerous state/federal financial assistance programs and/or qualification for a Tufts Medical Center discount. The Financial Coordinator assists the billing department in collecting payments for the Hospital and Physician Organization prior to or after the date of service. The Financial Coordinator will work closely with the Patient Estimator to collect patient estimates prior to services rendered, when applicable.

Qualifications

JOB KNOWLEDGE AND SKILLS:

• Level knowledge generally acquired through completion of a Bachelor's degree with courses in business management or social sciences or comparable experience.
• Two to three years experience in a community service environment such as a Hospital or Medicaid Agency.
• In-depth knowledge of medical terminology and its relationship in establishing certifiable disabilities.
• In-depth knowledge of Tufts MC Financial Assistance and Credit and Collection Policies.
• Excellent interpersonal skills required to interact effectively with patients, their families, the medical staff, QSS, and other departments within the facility, as well as many outside agencies.
• Ability to grasp, retain, and apply new regulations and procedural changes both within the institution and to outside agencies.
• Complete understanding in the application of health insurance benefits to hospital and professional charges.
• Ability to handle stressful situations involving critically ill patients and other sensitive issues which involve finances.
• Good written communication skills.
• Excellent systems skills. Ability to work in a complex systems environment and understand spreadsheets and other business technologies.
• Completes required state and Hospital trainings including the Certified Application Counselor training and incorporates all changes implemented in the ACA regulations into daily work.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Constant contact with patients, patient families, and medical staff.
• There are some occasions when patients are on precautions and a gown and mask must be worn when interviewing. There are other situations when patients may be violent and the correct approach by the Financial Coordinator is invaluable, when trying to extract financial information.

Additional Information 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.