Ambulatory Service Rep II - Orthopedic Surgery

Roslindale; Boston (MA); Hybrid; USD 31,000 - 38,000; Full time

Job summary

BMCHS in Boston’s Orthopedic Clinic seeks an Ambulatory Service Rep II to support clinical operations with billing and managed care tasks, including charge entries, edits, and reconciliations, while also assisting with front-end patient access and registration.

Responsibilities include insurance communications, MPI maintenance, appointment scheduling, pre-authorization, and referral coordination, along with general administrative duties.

Qualifications

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

Responsibilities

• Charge entry and batch controls.
• Billing edits and reconciliations.
• Responding to billing inquiries and communicating with insurance carriers.
• Front-end patient registration, insurance verification, and appointment scheduling.
• Pre-authorization and referral coordination.
• Administrative support and credentialing coordination.
• Adherence to organizational standards.

Skills

English communication

Customer service

Confidentiality

Multitasking

MS Word

MS Excel

MS Access

PowerPoint

Web/Internet

Medical billing systems

Education

HS/GED

Bachelor's degree

Associate's degree

Tools

MS Word

MS Excel

MS Access

PowerPoint

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

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

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.

Equal Opportunity Employer/Disabled/Veterans