Ambulatory Services Representative III - Cancer Care

Boston Medical Center (BMC) is more than a hospital. It´s a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New England. Emphasizing community-based care, BMC is committed to providing consistently excellent and accessible health services to all—and is the largest safety-net hospital in New England. The hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet – an integrated health care delivery systems that includes many community health centers. Join BMC today and help us achieve our Vision 2030 which is a long-term goal to make Boston the healthiest urban population in the world.

Position: Ambulatory Services Representative III

Department: Hematology and Oncology

Schedule: FT, 40 hours, Days

POSITION SUMMARY:

The incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: operation room (O.R.) scheduling, infusion scheduling, coordination of radiology scans, obtaining prior authorizations, front end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, and a variety of administrative duties in support of department (such as coordination of physician credentialing, handling forms, phones, filing, making appointments, photocopying, faxing, mailings, letters, reports, etc.).

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Primarily responsible for all results letters, appointments reminders, and other applicable procedure scheduling.
• Processes prior authorization and pre-certification work lists and referral reconciliations for procedures.
• Coordinates medical clearance documentation.
• Serves as backup for managing physician OR calendars.
• Serves as backup for OR block time and ensures utilization is maximized.
• Notifies leadership team of changes in physicians or patients’ schedules.
• 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
  • Referral work lists
  • Billing charge entry
  • Batch controls
  • Billing (TES) edits
  • Hold bill edits
  • Charge reconciliations
  • Billing and managed care functions
  • Provides physician and departmental support such as managing physician & manager calendars, schedule
  • Physician & managers’ administrative appointments, handles or routes calls to the department, verifies credentialing documents, etc.
  • Provides general administrative support to include, word processing, spreadsheets, presentation software to create and edit department documents and presentations; handling forms, phones, filing, making appointments, photocopying, faxing, mailings, etc.
  • Other relevant duties as needed.

JOB REQUIREMENTS

EDUCATION and EXPERIENCE:

• Bachelor’s degree plus 1 – 2 years relevant work experience or
• Associates degree plus at least 3 years relevant experience or
• HS/GED with 5+ year’s relevant experience.

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, and PowerPoint) and web/internet is required. Experience with standard hospital registration & billing systems or ability to learn such systems is also required.

Equal Opportunity Employer/Disabled/Veterans