Ambulatory Service Representative - Pediatric Orthopedics

CHRISTUS Health•San Antonio, TX

About The Position

Performs a variety of complex administrative duties for patients needing routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assesses patients' needs, including financial counseling, interpreter services, and social services, and refers them to the appropriate person or area. Alerts providers to emergent patient care needs.

Requirements

High school diploma.

Responsibilities

Receives and directs phone calls from patients and physician offices.
Schedules patients for treatment by multiple providers and treatment areas, and arranges associated tests and procedures according to established guidelines and specific criteria.
Prioritizes appointments to foster optimum patient care and efficient use of physicians' clinical staff, equipment, and facilities.
Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns.
Schedules urgent care appointments as needed and directed by a physician.
Greets patients for scheduled and/or urgent care appointments and procedures.
Confirms and verifies patient demographic and insurance information.
Collects co-payments from patients upon arrival when applicable.
Obtains patient or guardian consent signatures for treatment authorization and insurance/billing information.
Collaborates with insurers to obtain prior authorizations for procedures and tests as needed.
Follows insurer guidelines to ensure pre-authorization, pre-certification, and physician referrals are obtained before patient visits.
Reviews and audits billing discrepancy reports and researches errors for resolution.
Verifies eligibility for procedures or tests from various health care institutions.
Maintains accurate and timely records, logs, charges, files, and other related information as required.