Managed Care Services Rep-Ambulatory PAS-20 Hrs, Days-SEIU Boston, MAApply Job ID 5716760 Date posted 09/13/2017
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. BMC provides a full range of pediatric and adult care services, from primary to family medicine to advanced specialty care.
BMC is also committed to our employees, who are a very important piece to who we are. We pride ourselves in providing equal employment opportunity and non-discrimination for all employees and qualified applicants without regard to a person's race, color, gender, age, religion, national origin, ancestry, disability, veteran status, genetic information, sexual orientation or any characteristic protected under applicable law. BMC will make reasonable accommodations for qualified individuals with known disabilities, in accordance with applicable law.
The Managed Care Services Representative (MCSR) is primarily responsible for working collaboratively with primary care practices, specialty practices, referring physicians, primary care physicians, insurance carriers, patients and any other parties to ensure that required managed care referrals and prior authorizations for specified specialty visits and other services are obtained and appropriately recorded in the relevant practice management systems for patient appointments/visits. The MCSR will communicate with patients, physicians and insurance carrier representatives as necessary in order to accomplish this, utilizing available reports to follow-up on unresolved issues and denied claims. The MCSR is responsible for performing various administrative and clerical duties required to support these functions and, on an as-needed basis, may be required to perform other tasks.
Associates Degree or High School Diploma plus equivalent experience.
1-2 years previous experience in a customer service role within a healthcare setting is preferred.
Exceptional interpersonal skills, including the ability to establish and maintain effective relationships with patients, physicians, management, staff, and other customers.
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.
Excellent verbal communication skills.
Able to communicate effectively in writing.
Basic computer proficiency inclusive of ability to access, enter and interpret computerized data/information.