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Ambulatory Service Representative, Maternal Fetal Medicine Specialist
1 month ago
We are seeking a highly skilled and detail-oriented Ambulatory Service Representative to join our Maternal Fetal Medicine team at UMass Memorial Health. In this role, you will provide exceptional patient care and administrative support to our patients and clinicians.
Key Responsibilities- Greet and assist patients and visitors, ensuring a positive and welcoming experience.
- Verify patient demographic and insurance information, ensuring accuracy and compliance with regulatory requirements.
- Collect co-payments from patients and maintain accurate records.
- Obtain signatures of consent from patients/guardians for treatment authorization and insurance/billing information.
- Assess patients' needs and refer to appropriate resources, including financial counseling, interpreter services, and social services.
- Receive and direct phone calls, connecting patients with clinicians or taking messages as directed.
- Schedule urgent care appointments and arrange tests and procedures according to established guidelines and criteria.
- Prioritize appointments to optimize patient care, efficient utilization of clinical staff, and resources.
- Ensure test and procedural prep information is provided to patients verbally, via mail, or through the patient portal as necessary.
- Collaborate with insurers to obtain prior-authorizations for procedures and tests as needed.
- Follow guidelines established by insurers to ensure pre-authorization, pre-certification, and clinician referrals for treatment are obtained prior to patient visits.
- Comply with referral management regulations and verify eligibility for procedures or tests from various healthcare institutions.
- Follow up to correct discrepancies and facilitate patient prescription renewal matters within scope of authority as directed by clinicians.
- Prep patient information for clinicians and scrub patient encounter information for electronic submission.
- Review and audit billing discrepancy reports and research errors for resolution as directed by office or clinical management.
- Maintain accurate and timely records, logs, charges, files, and other related information as required.
- Perform administrative and clerical duties, including retrieving files, distributing mail, faxing, collating, data entry, and relaying messages to clinicians, residents, and staff.
- Prepare special reports or spreadsheets for clinicians as requested.
- Collect co-payments from patients and maintain records or make daily cash deposits from patient visits.
- Calculate daily totals of co-payments received for submission to the second tier for co-payment reconciliation.
- Compose or select standard form letters for clinician's response to routine inquiries and procedures.
High school diploma required; associate's or bachelor's degree preferred. Three years of related experience, or equivalent combination of education and experience, is required. Multifunctional and able to work under stressful situations, with excellent communication and human relations skills.
This role primarily supports the Maternal Fetal Medicine, OB Ultrasound, and Antenatal Testing Unit. The position will cover all other divisions within the Department of OBGYN based on operational needs. The position will rotate evening coverage on W/Th.
UMass Memorial Health is an equal opportunity and affirmative action employer, committed to diversity, equity, and inclusion. We welcome applications from individuals with varied experiences, perspectives, and backgrounds.
