Ambulatory Service Representative

Exemption Status

Non-Exempt

$20.94 - $33.59

Final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations.

Monday through Friday, 9‑5:30, Day Shift, 8 Hours (United States of America)

At UMass Memorial Health, we provide exceptional patient care, academic excellence, and leading‑edge research. This role 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. Responsibilities include assessing patients' needs—including financial counseling, interpreter services, and social services—and referring to appropriate personnel.

• Greets visitors and/or patients for scheduled and/or urgent care appointments and procedures.
• Confirms and verifies patient demographic and insurance information.
• Collects 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, and 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, and resources.
• Ensures tests and procedural prep information is provided to patients verbally, by 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.
• Facilitates 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 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.
• Prepares special reports or spreadsheets for clinicians as requested.
• Collects co‑payments from patients for visits, maintains records, and 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.

• Complies with established departmental policies, procedures, and objectives.
• Attends a variety of meetings, conferences, seminars as required or directed.
• Demonstrates use of Quality Improvement in daily operations.
• Complies with all health and safety regulations and requirements.
• Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility, and acceptance toward all employees, patients and visitors.
• Maintains regular, reliable, and predictable attendance.
• Per…