Ambulatory Services Representative II-U(Psychiatry Clinic)

Boston Medical Center (BMC) is more than a hospital. Its a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New England. Emphasizing community-based care BMC is committed to providing consistently excellent and accessible health services to all-and is the largest safety-net hospital in New England. The hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet - an integrated health care delivery systems that includes many community health centers. Join BMC today and help us achieve our Vision 2030 which is a long-term goal to make Boston the healthiest urban population in the world.

Position: Ambulatory Services Representative II
Department: Psychiatry Clinic
Schedule: Full Time

POSITION SUMMARY:

The incumbent is responsible for coordinating all the functions and activities related to patient access for Nuclear Medicine Nuclear Cardiology Molecular Imaging and Radioisotope Therapies including but not limited to; appointment scheduling front end customer service verification of patient registration insurance/coverage verification charge entry and a variety of administrative duties in support of department (such as coordination of physician radioisotope therapy scheduling handling forms phones filing making appointments photocopying faxing mailings letters reports etc).

ESSENTIAL RESPONSIBILITIES / DUTIES:

Primarily responsible for Nuclear Medicine scheduling for all departmental cases including all imaging and therapy appointments and other applicable procedure scheduling.

• Work with referring departments for prior authorization and pre-certification.

• Coordinates medical clearance documentation.

• Manages physician Radioisotope Therapy calendars.

• Manager radioisotope Therapy dose orders.

• Manage scanner and treatment room block time and ensures utilization is maximized.

• Manage Radioisotope Therapy team i.e. Radiation Safety nursing and physicians of scheduled patients.

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

• Billing 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 physician and departmental support such as managing physician & manager calendars schedule physician & managers administrative appointments handles or routes calls to the department verifies credentialing documents etc.

Provides general administrative support to include word processing spreadsheets presentation software to create and edit department documents and presentations; handling forms phones filing making appointments photocopying faxing mailings etc.

Other relevant duties as needed

Must adhere to all BMCs RESPECT behavioral standards

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

• HS/GED plus 3 years relevant experience.

• Bachelors degree or

• Associates plus 1 year relevant experience

EXPERIENCE:

(See above under education requirements)

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