Ambulatory Services Representative II

POSITION SUMMARY: The incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: front/back end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, billing and managed care, and a variety of administrative duties in support of department (such as coordination of physician credentialing, handling phones & mail, filling out forms, filing, photocopying, faxing, preparing letters, reports, processing referrals etc.). The incumbent in this role will support the clinical practice by focusing on billing and managed care functions (including charge entries, billing edits, charge reconciliations, responding to billing inquires, corresponding with insurance carriers, investigating billing discrepancies, etc.). May also support the clinic with front-end customer service, patient registration, insurance/coverage verification, Referrals and a variety of administrative duties, as needed. Position: Ambulatory Services Representative II Department: Primary Clinic Schedule: Full Time ESSENTIAL RESPONSIBILITIES / DUTIES: Focuses on one or more of the following areas, and provides support as needed to optimize daily flow: Charge entry Batch controls Billing (TES) edits Hold bill edits Charge reconciliations Billing and managed care functions (including responding to billing inquires, corresponding with insurance carriers, and investigating discrepancies, etc.). Provides general administrative support to include, word processing, spreadsheets, presentation software to create and edit department documents and/or presentations. Provides physician and departmental support such as managing physician & manager calendars, scheduling physician & managers' administrative appointments, answering departmental calls, credentialing documents, etc. In addition, performs a wide variety of administrative duties to ensure proper functioning of assigned department including, but not limited to: 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 referral reconciliation Referral work lists Provides a variety of administrative duties in support of the practice (such as handling phones & mail, filling out forms, filing, photocopying, faxing, preparing letters, reports, etc). Adheres to all of BMC's RESPECT behavioral standards. JOB REQUIREMENTS JOB REQUIREMENTS EDUCATION: HS/GED plus 3+ years relevant experience. Bachelors degree or Associates plus 1 year relevant experience EXPERIENCE: Experience with medical billing or similar setting preferred. KNOWLEDGE AND SKILLS: Excellent English communication skills (oral and written) and interpersonal skills are required 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 and knowledge of Microsoft Office applications (MS Word, Excel, Access, PowerPoint) and web/internet is required. Experience with standard hospital registration & billing systems or ability to learn such systems is also required. Compensation Range: $22.36- $27.26 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or "apps" job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment. Working at Boston Medical Center is more than a job. It's a chance to make a difference as part of our mission to provide exceptional and equitable care to all. As a nationally-recognized leader in health equity, nursing, initiatives to combat climate change, and many other areas, BMC is dedicated to improving the health of our community in Boston and beyond. BMC's mission to provide exceptional care without exception extends to our employees, and we have been recognized as a top employer and best place to work. A strong sense of teamwork and support for our staff are the bedrock of BMC, as we know that we can only provide exceptional care to patients when our staff are cared for too. Boston Medical Center is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to Talentacquisition@bmc.org or call 617-638-8582 to let us know the nature of your request. Boston Medical Center participates in the Electronic Employment Verification Program. As an E-Verify employer, prospective employees of BMC must complete a background check before beginning their employment at the hospital. BMC requires all staff to be vaccinated against COVID-19 and flu, as well as receive a booster dose of the COVID-19 vaccine. According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or "apps" job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment. To avoid becoming a victim of an employment offer scam, please follow these tips from the FTC: FTC Tips