Managed Care Service Representative

Boston, MA | Contract to Perm

Post Date: 03/09/2018 Job ID: 80667 Specialty: Accounting & Finance

A healthcare organization in Boston, MA is seeking a Managed Care Service Representative to join their team. In this contract-to-hire role, you will be responsible for working collaboratively with primary care practices, specialty care practices, primary care physicians, referring physicians, and patients to ensure that required referrals are obtained and appropriately recorded in the relevant practice management systems prior to scheduled patient visits. Apply today!

Responsibilities for the Managed Care Service Representative:
  • Work collaboratively with practices to obtain missing referrals for specialty services prior to scheduled visits
  • Document and track the number of referrals that are generated and obtained
  • Verify and update patient registration information, including insurance, demographic and patient data in order to perform referral management function
  • Interface with patients
  • Work with all support staff and leadership to prioritize and facilitate referral processes to maintain integrity of service standards
  • Develop a clear understanding of the various payor referral and authorization process and requirements for departmental policies and procedures
  • Receive inquiries from customers, investigate and disseminate information to requestor and wider audiences as appropriate
  • Work with Ontrac tool and reporting to review billing rejections to resolve insurance issues to maximize reimbursement
  • Identify need for escalation of issues or problems to appropriate supervisor or manager
Requirements for the Managed Care Service Representative:
  • 1-3 years Healthcare experience
  • Bachelor’ s Degree or equivalent experience
  • Call Center environment experience
  • Ability to communicate and interact effectively with all levels of hospital personnel
  • Ability to maintain confidentiality with regard to all phases of the work
  • Ability to withstand the pressure of continual deadlines and receipt of work with variable requirements
  • Ability to use standard office equipment including computers, photocopy and facsimile machines, and readers/printers
  • Excellent customer service skills
  • Computer Literate; knowledge of BICS, IDX, Percipio
  • Technology savvy with a strong knowledge working with Microsoft Office
  • Strong organizational skills with great attention to detail
  • Strong multi-tasking and prioritizing skills with the ability to meet deadlines
  • Excellent written and verbal communication skills
  • Strong interpersonal skills with a customer service focus
  • Ability to work independently and as part of a team
  • Must be eligible to work in the U.S. without sponsorship                     

Not ready to apply?

Send an email reminder to:

Share This Job:

Related Jobs: