The incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: operation room (O.R.) scheduling, front end customer service, patient registration, insurance/coverage verification, appointment scheduling, Referrals, charge entry, and a variety of administrative duties in support of department (such as coordination of physician credentialing, handling forms, phones, filing, making appointments, photocopying, faxing, mailings, letters, reports, etc.).
Position: Ambulatory Service Representative III
Department: OB/GYN Clinic
Schedule: Full Time
ESSENTIAL RESPONSIBILITIES / DUTIES:
- Primarily responsible for scheduling including all referrals, cases, pre-op appointments and other applicable procedure scheduling.
- Processes prior authorization and pre-certification work lists and reconciliations for operative cases (elective, urgent and emergent).
- Coordinates medical clearance documentation.
- Reception & customer service
- creating or verifying Master Patient Index (MPI)
- registration demographics
- visit management
- appointment scheduling (including consults, tests, in-office procedures, follow-up visits and cross-booking interpreters, social services, radiology, etc)
- insurance/coverage verification
- co-payment collection
- front-end review and correcting registration & insurance edits
- pre-authorization, referral coordination and referral reconciliation
- Referral work lists
- Billing charge entry
- Batch controls
- Billing (TES) edits
- Hold bill edits
- Charge reconciliations
- billing and managed care functions
- Provides physician and departmental support such as managing physician & manager calendars, schedule physician & managers’ administrative appointments, handles or routes calls to the department, verifies credentialing documents, etc.
- Provides general administrative support to include, word processing, spreadsheets, presentation software to create and edit department documents and presentations; handling forms, phones, filing, making appointments
JOB REQUIREMENTS
EDUCATION:
- Bachelor’s degree plus 1 – 2 years relevant work experience or
- Associates degree plus at least 3 years relevant experience or
- HS/GED with 5+ years relevant experience.
KNOWLEDGE AND SKILLS:
- Excellent English communication skills (oral and written) and interpersonal skills are required to interact with internal and external contacts in a courteous and patient focused manner.
- 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.
- Strong computer skills and knowledge of Microsoft Office applications (MS Word, Excel, Access, PowerPoint) and web/internet is required. Experience with standard hospital registration & billing systems or ability to learn such systems is also required.