Boston Medical Center Boston , MA 02298
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 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 plus 1 - 2 years experience or HS/GED plus 3 + years experience.
At least one year of experience must be in a customer service role. Experience with managed care in 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