Ambulatory Services Representative II

Roslindale; Boston (MA); Hybrid; USD 30,000 - 37,000; Full time

Job summary

The Ambulatory Services Representative II at BMCHS supports the clinical practice by focusing on billing and managed care functions, including charge entry, edits, reconciliations, and inquiries. May also assist with front-end patient registration and visit management.

Key tasks include MPI, demographics verification, scheduling, insurance verification, co-pay collection, pre-authorization, referrals, and general admin support. Strong English communication and confidentiality are essential.

Qualifications

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

Responsibilities

• Charge entry and billing edits.
• Batch controls and charge reconciliations.
• Billing and managed care functions including inquiries and insurance communications.
• Front‑end registration, MPI, demographics and visit management.
• Pre-authorization and referral coordination.

Skills

English communication

Customer service

Confidentiality

Multitasking

MS Office

Education

HS/GED + 3+ years relevant experience

Associates +1 year relevant experience

Bachelor's degree

Tools

Microsoft Office Suite

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.

Position: Ambulatory Services Representative II

Department: Cardiovascular Center

Schedule: Full Time, 40 hours, 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

• 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