Ambulatory Services Representative III - Eye Clinic

BMC Software•Boston, MA

1d•Onsite

About The Position

The incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: operation room (O.R.) scheduling, 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 coordination of physician credentialing, handling forms, phones, filing, making appointments, photocopying, faxing, mailings, letters, reports, etc.). This position is primarily responsible for Surgical scheduling for all departmental cases including all pre-op appointments and other applicable procedure scheduling. It also involves processing prior authorization and pre-certification work lists and reconciliations for operative cases (elective, urgent and emergent), coordinating medical clearance documentation, managing physician OR calendars, and managing OR block time to ensure utilization is maximized. Additionally, the role includes general administrative support such as 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 reconciliation, billing charge entry, batch controls, billing (TES) edits, hold bill edits, charge reconciliations, and managed care functions. The role also provides physician and departmental support, including managing calendars, scheduling administrative appointments, handling calls, and verifying credentialing documents, as well as general administrative support like word processing, spreadsheets, presentation software, handling forms, phones, filing, making appointments, photocopying, faxing, and mailings.

Requirements

Bachelor's degree plus 1 - 2 years relevant work experience OR Associate's degree plus at least 3 years relevant experience OR HS/GED with 5+ years relevant experience.
1-5 years of experience depending on degree.
Excellent English communication skills (oral and written).
Excellent interpersonal skills 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.
Knowledge of Microsoft Office applications (MS Word, Excel, Access, PowerPoint).
Knowledge of web/internet.
Experience with standard hospital registration & billing systems or ability to learn such systems.

Responsibilities

Coordinating all the functions and activities related to patient access including O.R. scheduling, front end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, and a variety of administrative duties.
Primarily responsible for Surgical scheduling for all departmental cases including all pre-op appointments and other applicable procedure scheduling.
Processes prior authorization and pre-certification work lists and reconciliations for operative cases (elective, urgent and emergent).
Coordinates medical clearance documentation.
Manages physician OR calendars.
Manages OR block time and ensures utilization is maximized.
Cancels blocks within 30 days.
Notifies Pre-Surgical Services of changes in physicians or patients’ schedules.
Performs reception & customer service duties.
Creates or verifies Master Patient Index (MPI) registration demographics.
Manages patient visits.
Schedules appointments (including consults, tests, in-office procedures, follow-up visits and cross-booking interpreters, social services, radiology, etc.).
Performs insurance/coverage verification.
Collects co-payments.
Conducts front-end review and correcting registration & insurance edits.
Manages pre-authorization, referral coordination and referral reconciliation.
Manages Referral work lists.
Performs Billing charge entry.
Manages Batch controls.
Handles Billing (TES) edits.
Manages Hold bill edits.
Performs Charge reconciliations.
Handles billing and managed care functions.
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.
Performs other relevant duties as needed.