Ambulatory Service Representative

Ambulatory Service Representative

Boston, MA

Job Description

The incumbent in this role will support the clinical practice by focusing on billing and managed care functions (including charge entries, billing edits, charge reconciliations, responding to billing inquires, corresponding with insurance carriers, investigating billing discrepancies, etc). May also support the clinic with front-end customer service, patient registration, insurance/coverage verification, and a variety of administrative duties, as needed. The incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: front end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, billing and managed care, and a variety of administrative duties in support of department (such as coordination of physician credentialing, handling phones & mail, filling out forms, filing, photocopying, faxing, preparing letters, reports, etc.

Position: Ambulatory Services Representative II

Department: Radiation Oncology

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

Focuses on one or more of the following areas, and provides support as needed to optimize daily flow:

• Charge entry
• Batch controls
• Billing (TES) edits
• Hold bill edits
• Charge reconciliations

Billing and managed care functions (including responding to billing inquires, corresponding with insurance carriers, and investigating discrepancies, etc.). Provides general administrative support to include, word processing, spreadsheets, presentation software to create and edit department documents and/or presentations. Provides physician and departmental support such as managing physician & manager calendars, scheduling physician & managers' administrative appointments, answering departmental calls, credentialing documents, etc. In addition, performs a wide variety of administrative duties to ensure proper functioning of assigned department including, but not limited to:

• Reception & customer service
• creating or verifying Master Patient Index (MPI)
• registration demographics
• visit management
• appointment scheduling (including consults, tests, in-office procedures, follow-up visits and cross-booking interpreters, social services, radiology, etc.)
• insurance/coverage verification
• co-payment collection
• front-end review and correcting registration & insurance edits
• pre-authorization, referral coordination and referral reconciliation
• Referral work lists

Provides a variety of administrative duties in support of the practice (such as handling phones & mail, filling out forms, filing, photocopying, faxing, preparing letters, reports, etc.). Adheres to all of BMC's RESPECT behavioral standards.

JOB REUQIREMENTS:

EDUCATION:

• Bachelors degree or
• Associates plus 1 year relevant experience or
• HS/GED plus 3+ years relevant experience

CERTIFICATES, LICENSES, REGISTRATION REQUIRED:

• None

EXPERIENCE:

• 1-3 years of relevant experience depending on education
• Experience with medical billing or similar setting preferred

KNOWLEDGE AND SKILLS:

• Excellent English communication skills (oral and written) and interpersonal skills are required to interact with internal and external contacts in a courteous and patient focused manner.
• Demonstrated customer service skills, including the ability to use appropriate judgment, independent thinking and creativity when resolving customer issues.
• Must be able to maintain strict confidentiality of all personal/health sensitive information.
• Ability to effectively handle challenging situations and to balance multiple priorities.
• Strong computer skills and knowledge of Microsoft Office applications (MS Word, Excel, Access, PowerPoint) and web/internet is required.
• Experience with standard hospital registration & billing systems or ability to learn such systems is also required.

Skills : ADMINISTRATIVE DUTIES , ACCESS , MS WORD , SOCIAL SERVICES , AMBULATORY SERVICES