Ambulatory Services Representative, Advanced Therapeutics Pharmacy Remote

Ambulatory Services Representative, Advanced Therapeutics Pharmacy, 40hr, Day (Remote)

Are you a current UMass Memorial Health caregiver? Apply now through Workday.

Exemption Status: Non-Exempt

Hiring Range: $17.43 - $33.59

Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations .

Schedule Details: Monday through Friday

Scheduled

Hours:

8:30am-5:00pm

Shift: 1 - Day Shift, 8 Hours (United States of America)

Hours: 40

Cost Center: 10020 - 3834 ATRX Pharmacy

Union: SHARE (State Healthcare and Research Employees)

This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.

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.

• 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.
• Assesses 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.

Required:

• High School Diploma.

Prefer…