Ambulatory Service Rep, Community Women's Care, 40 Hour, Days

About the role

This position is for a caregiver at UMass Memorial Health, serving patients in an ambulatory in/outpatient setting. The role involves performing a variety of complex administrative duties, including scheduling appointments, verifying patient information, and communicating with patients and providers.

Responsibilities

• Greets visitors and patients for scheduled and urgent care appointments and procedures.
• Confirms and verifies patient demographic and insurance information.
• Collects co-payments from patients upon arrival.
• Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information.
• Affords financial counseling, interpreter services, social services, and refers to appropriate person or area.
• Receives and directs phone calls, 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 clinicians.
• 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 clinical staff, as well as resources.
• Ensures tests and procedural prep information is provided to patients verbally, mail, and/or by the patient portal as necessary.
• 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 clinician referrals for treatment are obtained prior to patient visits.
• Complies with referral management regulations.
• 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 clinicians.
• Preps the patient’s information for clinicians for scheduled patient visits as needed.
• Scrubs Patient Encounter information and submits electronically.
• Reviews and audits billing discrepancy reports and researches errors for resolution as directed by office or clinical management.
• Maintains accurate and timely records, logs, charges, files, and other related information as required.
• Performs a variety of related administrative and clerical duties, such as retrieving files, distributing mail and other records, faxing, collating, data entry, and relaying messages to clinicians, residents and staff.
• May prepare special reports or spreadsheets for clinicians as requested.
• Collects co-payments from patients for visits, maintains records or makes daily cash deposits from patient visits.
• Calculates daily totals of co-payments received for submission to the second tier for co-payment reconciliation.
• Composes, or selects standard form letters for clinician’s response to routine inquiries and procedures, such as back-to-school authorizations.

Qualifications

• Required: High School Diploma.
• Preferred: Associate’s or Bachelor’s degree.
• Required: 3 years of related experience, this requirement is waived if candidate has Associate’s or Bachelor’s degree.
• Requires the ability to use specialized applications software and computer systems.
• Necessitates individuals who are multifunctional and able to work under stressful situations.
• Exemplifies, professional behavior and excellent communication and human relations skills.
• Preferred: Knowledge of business office procedures and medical terminology/procedures preferred.

Skills

• Knowledge of business office procedures and medical terminology/procedures preferred.

Benefits

The position offers benefits that are competitive and aligned with industry standards. Specific details about benefits will be communicated during the hiring process.

Pay

The salary range for this position is $20.94 - $29.27 per hour. The final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Schedule

The schedule for this position is Monday through Friday, with scheduled hours of 8a-5p. The shift is 1 - Day Shift, 8 Hours.