Ambulatory Services Representative II

Boston Medical Center•Boston, MA

About The Position

The Ambulatory Services Representative II coordinates patient-access functions and activities, including front-end customer service, check-in, scheduling, outreach, registration, insurance and coverage verification, charge entry, billing, managed care, and related administrative support. The role focuses on one or more billing or patient-access areas and provides additional support as needed to optimize daily department flow. The position supports the Psychiatry - Community Behavioral Health Center and performs a variety of administrative and practice-support duties. These may include reception and customer service; patient record and visit management; appointment and referral coordination; copayment collection; registration and insurance-edit review; and handling phones, mail, forms, filing, copying, faxing, letters, and reports. The role may also provide physician and departmental support, including calendar management, appointment scheduling, credentialing documents, and answering departmental calls. The incumbent is expected to follow BMC’s RESPECT behavioral standards and maintain confidentiality of personal and health-sensitive information. This is a full-time, 40-hour-per-week position. The regular schedule is Monday through Friday, 8:00 AM–4:30 PM, except for a rotating weekend schedule. The posting states both “1 weekend a month” and “every 3rd weekend”; on a scheduled weekend, hours are 9:00 AM–5:00 PM Saturday and Sunday, with the preceding Friday and following Monday off.

Requirements

High school diploma or GED and at least 3 years of relevant experience, or an associate or bachelor’s degree and at least 1 year of relevant experience.
Excellent oral and written English communication and interpersonal skills to interact courteously and with a patient-focused approach with internal and external contacts.
Demonstrated customer-service skills, including appropriate judgment, independent thinking, and creativity when resolving customer issues.
Ability to maintain strict confidentiality of personal and health-sensitive information.
Ability to handle challenging situations effectively and balance multiple priorities.
Strong computer skills and knowledge of Microsoft Office applications, including Word, Excel, Access, and PowerPoint, and web/internet use.
Experience with standard hospital registration and billing systems, or ability to learn such systems.

Nice To Haves

Experience with medical billing or a similar setting.

Responsibilities

Coordinate patient-access functions, including front-end customer service, patient check-in, scheduling, outreach, registration, insurance and coverage verification, charge entry, billing, and managed care.
Perform charge entry, batch controls, billing edits, hold-bill edits, and charge reconciliations.
Support billing and managed-care functions, including responding to billing inquiries, corresponding with insurance carriers, and investigating discrepancies.
Provide general administrative support using word-processing, spreadsheet, and presentation software to create and edit department documents and presentations.
Provide physician and departmental support, including managing physician and manager calendars, scheduling administrative appointments, answering departmental calls, and handling credentialing documents.
Provide reception and customer service.
Create or verify Master Patient Index (MPI) information, registration demographics, and visit management details.
Schedule appointments, including consults, tests, in-office procedures, and follow-up visits; coordinate interpreter, social-service, and radiology appointments as needed.
Verify insurance and coverage and collect copayments.
Review and correct registration and insurance edits at the front end.
Coordinate pre-authorizations and referrals, reconcile referrals, and manage referral work lists.
Perform administrative duties such as handling phones and mail, completing forms, filing, photocopying, faxing, and preparing letters and reports.
Adhere to BMC’s RESPECT behavioral standards and maintain confidentiality of personal and health-sensitive information.