
The incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: front/back 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, processing referrals etc.). 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, Referrals and a variety of administrative duties, as needed.
Position Ambulatory Services Representative II
Department Primary Clinic
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 REQUIREMENTS
EDUCATION:
HS/GED plus 3+ years relevant experience.
Bachelors degree or
Associates plus 1 year relevant experience
EXPERIENCE
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.
Compensation Range:
$22.36- $27.26
This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.
Equal Opportunity Employer/Disabled/Veterans
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Boston Medical Center (BMC) is a 511-bed, equity-led academic medical center and a proud member of the Boston Medical Center Health System. BMC delivers a model of healthcare where innovative and equitable care empowers all patients to thrive. As a premier academic medical center in Boston, a national leader in clinical care, and the largest essential hospital in New England, BMC’s world-class clinicians provide comprehensive care in more than 70 specialties and subspecialties.
BMC understands that health equity is foundational to community wellbeing, and it requires transformative thinking, rewriting policies that have historically underserved communities, creating access to cutting-edge care for all, and co-creating programs with community partners that serve as national models for improving patient outcomes and experiences. We are invested in going above and beyond what is traditionally considered medicine to meet the needs of our communities and address disparities in clinical care and beyond.
By pioneering cutting-edge research and advancing scientific discovery, we are fostering a culture of innovation where novel treatments and therapies are not only effective but also accessible.
Boston Medical Center Health System is an integrated academic healthcare system that models a new kind of excellence in healthcare where clinical and operational innovation meets health equity and access. With more than 15,000 dedicated employees, BMC Health System is committed to advancing scientific discovery and access to care, partnering with our communities, and developing scalable approaches to restore and maintain health.
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