Ambulatory Services Representative II - Boston Medical Center

Position: Ambulatory Services Representative II

Location: Pulmonary

Schedule: Full Time

POSITION SUMMARY:

The incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: front 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, etc.).

ESSENTIAL RESPONSIBILITIES / DUTIES:

Warmly greet and welcome all patients and other customers into the Department of Radiology. Ascertain whether the patient or customer has an appointment.

• For patient appointments/visits, verify the appointment/visit information.
• For non-clinical appointments, notify the appropriate party regarding the customer's arrival.
• For any patient who does not have a scheduled appointment/visit, follow departmental protocols to determine how best to serve the patient's needs.

Direct customers to the appropriate waiting area and provide a brief explanation of what they should expect during their visit with Radiology. Additional duties include:

• Monitor the waiting room and manage related patient flow processes to ensure that customers are appropriately served.
• Describe the options related to available amenities.
• When there are potential service or process breakdowns, attempt to remedy the situation.
• When this is not possible, immediately inform a member of the team who is able to quickly resolve the issue.
• Provide updates to patients and other customers regarding delays, including providing updates when the duration of a previously communicated delay has changed significantly.
• Notify supervisor of any significant delays identified while monitoring the waiting room, if those changes were not anticipated or communicated.
• Maintain the waiting area throughout the day by arranging reading materials and/or toys to ensure that it is neat and ordered in appearance and meets appropriate customer service and safety standards.
• Contact housekeeping services when necessary if cleaning is required to maintain the waiting area.
• Ensure that patients' questions are appropriately answered and/or that appropriate follow-up is provided.

In addition, performs a wide variety of administrative duties to ensure proper functioning of assigned department including, but not limited to:

• 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
• 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.
• Assists department with emergency re-scheduling due to equipment down or other events.
• Assists technologists and Radiologists with incoming calls, add on-cases, and answers questions as appropriate.
• 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
• front-end review and correcting registration & insurance edits
• pre-authorization, referral coordination and referral reconciliation
• Referral and Appointment Request work lists
• Needs to work closely with the techs for urgent or specific exams.
• Reaches out to providers if exams are not ordered correctly.
  
  • Adds providers into the system if they are new to BMC when transcribing
• 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).
• Provides high quality customer service to all patients and provider offices, internal and external to the Boston Medical Center Health System, throughout all incoming and outgoing phone calls and fax communication
• Maintains patient confidentiality.
• Utilizes hospital's Values as the basis for decision-making and to facilitate the division's hospital mission.
• Follows established hospital infection control and safety procedures.
• Performs other duties as assigned or as necessary.

EDUCATION:

• HS/GED plus 3+ years relevant experience.
• Bachelors degree or
• Associates plus 1 year relevant 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.

Req id: 31366