Ambulatory Service Rep III - The Woodlands

UnitedHealth Group•Shenandoah, TX

1d•$20 - $36

About The Position

The Ambulatory Service Rep III performs detailed duties across financial review, patient service, PBX operation, appointment scheduling, and medical records, as assigned by the site manager. The role helps patients move efficiently through clinic processes and ensures information is accurately collected, documented, communicated, and billed. Financial review duties include reviewing patient notes and account balances; determining payment sources and insurance eligibility; documenting eligibility information and amounts due in Epic; counseling patients about balances; reporting discrepancies; and supporting billing and managed-care functions such as charge entry, billing edits, charge reconciliation, billing inquiries, and investigations of billing discrepancies. The role may also assist with patient registration, coverage verification, check-in, and check-out. Patient service duties include providing information about wait times, answering questions or referring patients to the appropriate department, assisting with forms, updating demographics and insurance details in Epic, and processing registrations and patient encounters. The role collects fees, copays, deductibles, and coinsurance; issues receipts; performs cash-control and reconciliation procedures; and ensures charges and revenue-generating encounters are accurately closed. As a PBX operator, the role answers, screens, and directs calls; takes complete messages; maintains current extension lists; manages call forwarding at scheduled times; and reports complaints. Appointment duties include scheduling appointments and providing instructions or preparation details for ancillary appointments, as well as confirming future appointments. Medical records duties include retrieving, routing, tracking, and filing records; prioritizing requests; protecting patient confidentiality; making internal transportation runs; and forwarding records to Release of Information with appropriate authorization. Other duties may be assigned by site management.

Requirements

High school diploma or GED from an accredited program.
At least 2 years of medical office experience including face-to-face customer service, cash handling, patient registration, appointment scheduling, medical billing, and answering a multiline telephone system; or at least 1 year of Kelsey-Seybold Clinic experience as an Ambulatory Service Representative II.
EMR experience and experience with Microsoft Word and Excel.
Familiarity with medical terminology.
Excellent customer service skills in person and over the telephone.
Fluency in spoken and written English.
Professional demeanor and appearance.

Nice To Haves

At least 3 years of experience in a physician, hospital, or medical office environment.
At least 2 years of insurance or managed-care experience, including insurance verification and the ability to distinguish, understand, and explain plan types such as HMO, PPO, and EPO.
Epic experience.
Solid computer skills and knowledge of Microsoft Office applications, including Word, Excel, and PowerPoint, and web/Internet use.
Demonstrated customer service skills, including appropriate judgment, independent thinking, and creativity in resolving customer issues.
Ability to maintain strict confidentiality of personal and health-sensitive information.
Ability to handle challenging situations effectively and balance multiple priorities.
Bilingual English and Spanish oral and written communication skills, with interpersonal skills to interact courteously and with a patient focus with internal and external contacts.

Responsibilities

Review patient notes and account information, determine payment sources and insurance eligibility, and document findings.
Review outstanding balances, explain findings to patients when needed, and report discrepancies to the Patient Account Department or Central Business Office.
Document balances, deductible status, copay and coinsurance amounts, and corporate billing information in Epic.
Support billing and managed-care functions, including charge entry, billing edits, charge reconciliation, responding to billing inquiries, communicating with insurers, and investigating discrepancies.
Assist with front-end customer service, patient registration, insurance and coverage verification, and patient check-in/check-out.
Help patients complete required forms, communicate wait times, answer questions or refer patients to appropriate departments, and update demographics and insurance information in Epic.
Obtain corporate account or Workers’ Compensation information and ensure appropriate billing and reporting.
Process patient check-in and check-out in Epic, collect applicable fees and patient responsibility amounts, and issue receipts.
Perform daily cash-control procedures and reconcile the point-of-sale system within 48 hours of service, ensuring accurate charge capture and closure of revenue-generating encounters.
Register new patients, including searching names, converting pseudo numbers, setting up accounts, entering insurance and demographic information, and scanning insurance cards into Epic.
Answer, screen, and direct incoming calls; take complete messages; maintain physician and department extension lists; manage scheduled call forwarding; and report complaints promptly.
Schedule appointments and ancillary services, provide instructions and preparations when necessary, and confirm future appointments as directed.
Retrieve, route, track, prioritize, file, and forward medical records according to clinic standards and confidentiality procedures.
Perform regular internal records transportation runs and forward records to Release of Information when appropriate authorization is available.
Perform other duties as assigned by site management.