Ambulatory Services Representative, Kidney Acquisition - 40 hours, Days

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

I. Performs a variety of complex administrative duties for patients in need of routine and / or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in / outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs

II. Major Responsibilities :

• Greets visitors and / or patients for scheduled and / or urgent care appointments and procedures.
• Confirms and verifies patient demographic and insurance information.
• May collect co-payments from patients upon arrival.
• Obtains signatures of consent from patient / guardian for treatment authorization and insurance / billing information.
• Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area.
• Receives and directs phone calls.
• Connects the patient's call to the provider or responds to the patient and takes messages as directed.
• Schedules urgent care appointments as needed and directed by clinicians.
• Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria.
• Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of clinical staff, as well as resources.
• Ensures tests and procedural prep information is provided to patients verbally, mail, and / or by the patient portal as necessary.
• Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed.
• Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and clinician referrals for treatment are obtained prior to patient visits.
• Complies with referral management regulations.
• Verifies eligibility for procedures or tests from various health care institutions.
• Follows up to correct discrepancies.
• May facilitate patient prescription renewal matters, (via telephone, fax, and email), within scope of authority as directed by clinicians.
• Preps the patient's information for clinicians for scheduled patient visits as needed.
• Scrubs Patient Encounter information and submits electronically.
• Reviews and audits billing discrepancy reports and researches errors for resolution as directed by office or clinical management.
• Maintains accurate and timely records, logs, charges, files, and other related information as required.
• Performs a variety of related administrative and clerical duties, such as retrieving files distributing mail and other records, faxing, collating, data entry, and relaying messages to clinicians, residents and staff.
• May prepare special reports or spreadsheets for clinicians as requested.
• Collects co-payments from patients for visits, maintains records or makes daily cash deposits from patient visits.
• Calculates daily totals of co-payments received for submission to the second tier for co-payment reconciliation.
• Composes, or selects standard form letters for clinician's response to routine inquiries and procedures, such as back-to-school authorizations.

Position Qualifications : License / Certification / Education :

Required : High School Diploma. Preferred : Associate's or Bachelor's degree.

Experience / Skills :

Required : 3 years of related experience, this requirement is waived if candidate has Associate's or Bachelor's degree. Requires the ability to use specialized applications software and computer systems. Necessitates individuals who are multifunctional and able to work under stressful situations. Exemplifies professional behavior and excellent communication and human relations skills. Preferred : Knowledge of business office procedures and medical terminology / procedures preferred.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We're striving to make respect a part of everything we do at UMass Memorial Health for our patients, our community and each other. Our six Standards of Respect are : Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.