Ambulatory Service Representative II - Orthopedic Surgery

BMC Software•Boston, MA

1d•Onsite

About The Position

The incumbent is responsible for coordinating all the functions and activities related to ambulatory patient access including, but not limited to: front end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, and a variety of administrative duties in support of department (such as, handling forms, phones, filing, making appointments, photocopying, faxing, mailings, letters, reports, etc.). The position focuses on one or more areas to optimize daily flow, such as charge entry, batch controls, billing edits, hold bill edits, charge reconciliations, and billing and managed care functions. It also provides general administrative support, physician and departmental support, and a wide variety of administrative duties to ensure proper functioning of the assigned department.

Requirements

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

Nice To Haves

Experience with medical billing or similar setting preferred.

Responsibilities

Coordinate all the functions and activities related to ambulatory patient access including front end customer service, patient registration, insurance/coverage verification, appointment scheduling, and charge entry.
Perform a variety of administrative duties in support of the department, such as handling forms, phones, filing, making appointments, photocopying, faxing, mailings, letters, and reports.
Focus on one or more of the following areas, and provide support as needed to optimize daily flow: Charge entry, Batch controls, Billing (TES) edits, Hold bill edits, Charge reconciliations.
Perform billing and managed care functions, including responding to billing inquiries, corresponding with insurance carriers, and investigating discrepancies.
Provide general administrative support to include word processing, spreadsheets, presentation software to create and edit department documents and/or presentations.
Provide physician and departmental support such as managing physician & manager calendars, scheduling physician & managers’ administrative appointments, answering departmental calls, and handling credentialing documents.
Perform a wide variety of administrative duties to ensure proper functioning of assigned department including: 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.).
Conduct insurance/coverage verification, co-payment collection, front-end review and correcting registration & insurance edits.
Manage pre-authorization, referral coordination and referral reconciliation, including referral work lists.
Adhere to all of BMC’s RESPECT behavioral standards.