Ambulatory Service Rep, Pediatrics Clinic, 40 Hour, Days

UMass Memorial Health • Worcester, MA

5d

About The Position

The Ambulatory Service Rep performs complex administrative duties for patients requiring routine or urgent appointments, procedures, tests, and related services in an ambulatory or outpatient setting. The role assesses patient needs—including financial counseling, interpreter services, and social services—and directs patients to appropriate resources. The position also alerts providers to emergent patient-care needs.

The representative supports the patient visit from scheduling and registration through follow-up and billing-related administration. This includes greeting patients, verifying demographic and insurance information, obtaining treatment and billing consents, collecting co-payments, coordinating appointments and tests, securing authorizations and referrals, and preparing patient information for clinicians. The role handles calls and messages, maintains records, supports billing discrepancy resolution, and performs other administrative and clerical duties.

This is a 40-hour-per-week day-shift position at the Pediatrics Clinic. The schedule is Monday through Friday, with every fourth weekend scheduled. Shifts are eight hours with varying start times within the stated 7:30 a.m.–5:30 p.m. schedule. The work is sedentary and performed indoors in a patient-care environment.

Requirements

• High school diploma.
• Three years of related experience; this experience 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.
• Knowledge of medical terminology and procedures.

Responsibilities

• Greet visitors and patients arriving for scheduled or urgent-care appointments and procedures.
• Confirm and verify patient demographic and insurance information.
• 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 callers to providers or respond and take messages as directed.
• Schedule urgent-care appointments as directed by clinicians.
• Schedule patients 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 needed.
• Collaborate with insurers to obtain prior authorizations for procedures and tests.
• Follow insurer guidelines to obtain pre-authorization, pre-certification, and clinician referrals before patient visits.
• Comply with referral management regulations and verify eligibility for procedures or tests at healthcare institutions.
• Follow up to correct discrepancies.
• Facilitate prescription renewal matters by telephone, fax, or email within the role’s authority and as directed by clinicians.
• Prepare patient information for clinicians before 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.
• Collect patient co-payments, maintain related records, and make daily cash deposits from patient visits as applicable.
• Calculate daily co-payment totals for submission for second-tier reconciliation.
• Compose or select standard form letters for clinician responses 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, and apply quality improvement in daily operations.
• Demonstrate respectful and professional conduct toward employees, patients, and visitors, and maintain regular, reliable, and predictable attendance.
• Perform other similar and related duties as required or directed.

Benefits

• A signing bonus may be available; eligibility will be confirmed by a member of the Recruitment Team during the interview process.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED