Lead Ambulatory Service Representative, OBGYN and CWC, 40 Hours, Days

UMass Memorial Health•Worcester, MA

3d•$22 - $37

About The Position

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Provides functional oversight to an assigned group of employees and performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients’ needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs.

Requirements

High School Diploma.
4+ years of related experience.
Ability to work independently with minimal supervision and lead and train a group of employees.
Excellent oral, written and interpersonal skills, proven organization skills and problem-solving ability.
Ability to use specialized applications software and computer systems.
Necessitates individuals who are multifunctional and able to work under stressful situations.

Nice To Haves

Knowledge of business office procedures and medical terminology/procedures.

Responsibilities

Receives and directs phone calls from patients and physician offices.
Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria.
Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician’s clinical staff, as well as equipment and facilities.
Handles urgent patient care calls according to department protocol.
May alert providers to emergent patient care symptoms and concerns.
Connects the patient’s call to the provider or responds to the patient and takes messages as directed.
Schedules urgent care appointments as needed and directed by physician.
Ensures tests and procedural prep information is provided to patients both verbally and by mail as necessary.
Arrives and greets patients for scheduled and/or urgent care appointments and procedures.
Confirms and verifies patient demographic and insurance information.
May collect co-payments from patients upon arrival.
Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information.
Assess patients’ needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area.
Collaborates with insurers to obtain patients’ prior-authorizations for procedures and tests as needed.
Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits.
Complies with referral management regulations established for primary care providers.
Verifies eligibility for procedures or tests from various health care institutions.
Follows up to correct discrepancies.
May facilitate patient prescription renewal matters,( via telephone, fax, and email), within scope of authority as directed by providers.
Distributes and monitors the flow of work for an assigned group of employees.
Provides training and technical assistance to employees within the assigned work area.
Assists supervisor in assuring that assigned employees are provided with appropriate resources, materials, and methods.
Provides recommendations to manager or supervisor for the most efficient utilization of assigned personnel.
Relays work instruction from the supervisor.
Complies with established departmental policies, procedures, and objectives.
Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
Attends variety of meetings, conferences, and seminars as required or directed.
Demonstrates use of quality improvement in daily operations.
Complies with all health and safety regulations and requirements.
Maintains, regular, reliable, and predictable attendance.
Performs other similar and related duties as required or directed.