Ambulatory Service Rep, Pediatrics Clinic, 40 Hour, Days
About The Position
The Ambulatory Service Rep performs complex administrative duties for patients requiring routine or urgent appointments, procedures, tests, and associated ancillary services in an ambulatory/inpatient setting. The role assesses patients’ needs—including financial counseling, interpreter services, and social services—and refers them to the appropriate person or area. The representative also alerts providers to emergent patient care needs. This position supports patient access and clinic operations by greeting patients, verifying demographic and insurance information, coordinating appointments and procedures, assisting with prior authorizations and referrals, and maintaining accurate patient and billing records. It also involves phone support, clerical duties, payment processing, and collaboration with clinicians, insurers, and other healthcare institutions.
Requirements
- High school diploma.
- Three years of related experience; this requirement is waived for candidates with an associate’s or bachelor’s degree.
- Ability to use specialized application software and computer systems.
- Ability to perform multiple functions and work under stressful situations.
- Professional behavior and excellent communication and human relations skills.
Nice To Haves
- Associate’s or bachelor’s degree.
- Knowledge of business office procedures and medical terminology or procedures.
Responsibilities
- Greet visitors and patients arriving for scheduled or urgent care appointments and procedures.
- Confirm and verify patient demographic and insurance information.
- Collect patient co-payments when applicable, maintain related records, and make daily cash deposits from patient visits.
- Obtain patient or guardian signatures for treatment authorization and insurance or billing information.
- Assess patient needs, including financial counseling, interpreter services, and social services, and refer patients to appropriate resources.
- Receive and direct phone calls; connect calls to providers or respond to patients and take messages as directed.
- Schedule urgent care appointments as needed and directed by clinicians.
- Schedule treatment with multiple providers and treatment areas and arrange associated tests and procedures according to established guidelines and criteria.
- Prioritize appointments to support patient care and efficient use of clinical staff and resources.
- Provide patients with test and procedure preparation information verbally, by mail, or through the patient portal as appropriate.
- Collaborate with insurers to obtain prior authorizations for procedures and tests.
- Ensure pre-authorizations, pre-certifications, and clinician referrals are obtained before patient visits, following insurer guidelines.
- Comply with referral management regulations.
- Verify eligibility for procedures or tests at various healthcare institutions and follow up to correct discrepancies.
- Facilitate prescription renewal matters by telephone, fax, or email within the scope of authority and as directed by clinicians.
- Prepare patient information for clinicians ahead of scheduled visits as needed.
- Scrub patient encounter information and submit it electronically.
- Review and audit billing discrepancy reports and research errors for resolution as directed by office or clinical management.
- Maintain accurate and timely records, logs, charges, files, and related information.
- Perform administrative and clerical duties, including retrieving files, distributing mail and records, faxing, collating, data entry, and relaying messages.
- Prepare special reports or spreadsheets for clinicians as requested.
- Calculate daily co-payment totals for submission to the second tier for reconciliation.
- Compose or select standard form letters for clinicians responding to routine inquiries and procedures.
- Comply with departmental policies, procedures, objectives, and health and safety requirements.
- Attend meetings, conferences, and seminars as required or directed.
- Demonstrate quality improvement in daily operations and contribute to a professional, respectful, and inclusive environment.
- Maintain regular, reliable, and predictable attendance and perform other similar duties as required or directed.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
