Ambulatory Service Rep, Women's Services, 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 confirming patient information, scheduling appointments, and assisting with billing.

Responsibilities

• Greets visitors and patients for scheduled and urgent care appointments.
• 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 final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Pay

$20.94 - $29.27 per hour

Schedule

Monday through Friday, Weekends (Saturday and Sunday)

Scheduled Hours: 8a-5p

Shift: 1 - Day Shift, 8 Hours

Hours: 40