Job Information
Tufts Medicine Patient Financial Counselor in Boston, Massachusetts
We’re saving lives, building careers, and reimagining healthcare. We can’t wait to grow alongside you.
Location: Onsite at Tufts Medical Center
Hours: 40 hours per week; Monday through Friday from 8:00 AM to 4:30 PM
Job Profile Summary
This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Patient Financial Services duties: Facilitates the reimbursement for clinical services provided to patients. Submits claims to health insurers, follows up with health insurers about submitted claims, and performs appeals for non-clinical denials, etc. 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. An entry level role that typically requires little to no prior knowledge or experience, work is routine or follows standard procedures, work is closely supervised, and communicates information that requires little explanation or interpretation.
Job Overview
The position coordinates insurance verification and financial counseling for all patients within Tufts Medicine. This includes outpatient, inpatient, and ED patients. The position will assist and educate all uninsured and underinsured patients through the process of obtaining benefits so they can access the care they need and to ensure reimbursement to Tufts Medicine for the services provided.
Job Description
Minimum Qualifications:
High school diploma or equivalent
CAC Certification required within 4 weeks of hire
Preferred Qualifications:
Associates Degree
Three (3) years of hospital/health care experience in the areas of Patient Access
Experience with hospital information systems
One (1) year of hospital/health care experience in the areas of Patient Access
Valid driver’s license is required for local travel to remote hospital sites
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.
Ensures that all appropriate demographic and insurance information is captured on each inpatient admission. Verifies eligibility and benefit levels by the next business day following the date of admission.
Responsible for identifying patients who are Medicaid eligible and completing Medicaid applications for patients who fall within the Medicaid assistance guidelines. This includes interviewing family members, attorneys, outside social service agencies or other professionals as needed in order to obtain the information necessary to complete this process. Information pertaining to asset and income verification will also be required.
Meets with patients in the ED or inpatient care setting.
Communicates effectively and timely with patient/family and other colleagues within Tufts Medicine
Works collaboratively with Case Management, Social Work, MDs and other clinical team members.
Clearly documents all work completed in EMR.
Follows applications from submission through final decision. Updates EMRs accordingly and communicates with patients/families of the final decision and any next steps that need to be completed.
Assists patients with enrollment in Managed Care/ACO plans, enrollment via the Health Connector, employer sponsored insurance/COBRA, or Medicare plans.
Assists patients in applying for Tufts Medicine Financial Assistance application. Follows application from submission through final determination.
Assists patients in applying for disability benefits when applicable.
Monitors EPIC work queues assigned and meets daily/weekly productivity standards
Maintains current knowledge applicable to their role/position.
Maintains CAC Certification.
Physical Requirements:
Frequent sitting, occasional standing & walking, and lifting of 5-10 lbs
Mental requirements will be intense at times with involvement in many concurrent multi-faceted projects
Requires manual dexterity using fine hand manipulation to operate a computer keyboard or related equipment
Requires ability to see computer screen, monitoring equipment and reports
Skills & Abilities:
Knowledge of hospital and medical terminology experience
Familiarity with third party plans and medical billing
Knowledge of Masshealth/Medicaid system
4.. Must communicate effectively with co workers and leadership.
Tufts Medicine is a leading integrated health system bringing together the best of academic and community healthcare to deliver exceptional, connected and accessible care experiences to consumers across Massachusetts. Comprised of Tufts Medical Center, Lowell General Hospital, MelroseWakefield Hospital, Lawrence Memorial Hospital of Medford, Care at Home - an expansive home care network, and large integrated physician network. We are an equal opportunity employer and value diversity and inclusion at Tufts Medicine. Tufts Medicine does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation by emailing us at careers@tuftsmedicine.org .