Ambulatory Service Rep II - Orthopedic Surgery

bmc; Boston (MA); On-site; USD 30,000 - 37,000; Full time

Job summary

Boston Medical Center in Boston, MA seeks an Ambulatory Service Rep II to support the Orthopedic Clinic. You will handle billing and managed care tasks such as charge entries, billing edits, reconciliations, and inquiries with insurance carriers.

You will also assist with front-end patient services including registration, insurance verification, and appointment scheduling, plus a range of administrative duties in support of the department.

Qualifications

• HS/GED with 3+ years relevant experience.
• Bachelor's degree or equivalent.
• Associates with 1 year relevant experience.
• Experience with medical billing or similar setting preferred.

Responsibilities

• Charge entry and billing edits.
• Batch controls and reconciliations.
• Respond to billing inquiries and communicate with insurance carriers.
• Coordinate front-end patient registration and scheduling.
• Provide general administrative support and credentialing tasks.

Skills

English fluency

Customer service

Confidentiality

Multitasking

MS Office

Hospital systems

Education

HS/GED + 3+ years

Bachelor's degree

Associates +1 year

Tools

Medical billing systems

Job description

POSITION SUMMARY

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, and a variety of administrative duties, as needed.

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.).

Position : Ambulatory Service Rep II

Department : Orthopedic Clinic

Schedule : Full Time (40hrs, Days)

ESSENTIAL RESPONSIBILITIES / DUTIES

• 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.

• 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

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.

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.