Job Description

This position is responsible for the accurate and complete collection and capture of patient registration data for all outpatient areas of Tufts Medical Center. The Registration Coordinator is responsible for updating the registration system to make sure all relevant information has been captured and is accurate. The Registration Coordinators receive inbound phone calls, make outbound phone calls and also may have face-to-face interactions with the Tufts MC patients.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Reviews and works daily lists of future scheduled ambulatory visits to confirm the accuracy of insurance coverage.
• Verifies the validity of insurance coverage via eligibility tools. Ensures the appropriate plan codes has 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 any concerns with coverage after checking insurance eligibility.
• Contacts patients by telephone to confirm the accuracy of patient data and insurance subscriber information. Reconciles any conflicting information and enters updates into the registration system during the patient telephone interview.
•  Updates all future scheduled cases when any patient or insurance data is changed. Changes/Updates insurance plans codes for all future scheduled cases.
• Verifies the accuracy of primary care physician data When necessary, advises patients to contact their insurance company when this data conflicts.
• Sends escalations to the clinical areas, when needed. This includes when insurance is not active or the patient has a non-contracted plan.
•  Identifies duplicate medical record numbers and escalates cases accordingly.
•  Follows all policies and procedures to ensure patient verification is accurate and that patient confidentiality is protected.
• Refers cases to Financial Coordination for resolution when patients are uninsured or have a non-contracted plan and wish to be seen.
• Enters Medicare Secondary Payer questionnaire data appropriately including the detail obtained via the patient telephone interview.
• Works ONTRAC worklists in a timely manner to ensure patient’s information is accurately captured and insurance is verified prior to the date of service.
• Creates new Medical Record Numbers for patients who are new to Tufts MC.
• Provides excellent customer service to patients; answers questions appropriate for this position; maintains a positive image of Tufts MC.
• Maintains collaborative team relationships with peers in the Walk-in Centers, PreAuth Center, Admitting and Patient Finance departments in order to effectively achieve goals of continuous improvement in all processes.
• Performs other similar and related duties as required or directed.

Qualifications

• Strong customer service skills including excellent interpersonal and telephone skills. High degree of tact is necessary due to frequent interaction with patients, physicians, and insurance companies.
• Thorough knowledge and understanding of health care delivery systems especially Patient Access workflows. .
•  Thorough understanding of Medicare and Medicaid programs with the ability to identify primary payers.
• Ability to perform accurate data entry with basic word-processing skills.
• Excellent organizational skills required with attention to detail. Ability to prioritize work and be flexible with work assignments.
•  Fluency in a second language is helpful.

EDUCATION:

• Level of knowledge generally obtained via completion of an Associates degree.
• HS Diploma or equivalent is required

EXPERIENCE:

• One to two years of experience in insurance, managed care, private physician’s office practice or hospital registration setting is preferred.
• An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Works in a fast-paced, high-pressure office environment. There will be significant pressure to meet or exceed goals and expectations. There is little discomfort due to dust, dirt or other environmental factors.
• Constant contact with patients, internal and external physicians, payers and Tufts MC managerial staff.

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.