Ambulatory Service Representative - Pedi Endocrinology

CHRISTUS Health•San Antonio, TX

About The Position

Performs complex administrative duties for patients needing routine or urgent appointments, medical procedures, tests, and related 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. The role receives and directs calls; schedules patients across multiple providers and treatment areas; coordinates tests and procedures; and prioritizes appointments to support patient care and efficient use of staff, equipment, and facilities. It also greets patients, verifies demographic, insurance, and procedure eligibility information, collects applicable co-payments, obtains treatment and billing consents, and coordinates authorizations, certifications, and referrals with insurers. Additional duties include reviewing billing discrepancies, maintaining records and related information, performing clerical and administrative tasks, preparing reports or spreadsheets as requested, and complying with departmental policies and health and safety requirements. The representative contributes to a respectful and professional environment and performs other duties as required.

Requirements

High school diploma or GED.
Proficiency in software and computer systems.
Knowledge of business office terminology and procedures.
Ability to multitask and work under stressful situations.
Effective written and verbal communication skills.
At least 1 year of customer service experience.

Nice To Haves

Experience with medical office terminology.

Responsibilities

Receive and direct phone calls from patients and physician offices.
Schedule patients with multiple providers and treatment areas, and arrange associated tests and procedures according to established guidelines and criteria.
Prioritize appointments to foster optimum patient care and efficient use of clinical staff, equipment, and facilities.
Handle urgent patient care calls and alert providers to emergent symptoms and concerns.
Schedule urgent care appointments as needed and directed by a physician.
Greet patients for scheduled or urgent appointments and procedures.
Confirm and verify patient demographic and insurance information.
Collect applicable patient co-payments upon arrival.
Obtain patient or guardian signatures for treatment authorization and insurance or billing information.
Collaborate with insurers to obtain prior authorizations for procedures and tests.
Ensure required pre-authorizations, pre-certifications, and physician referrals are obtained before patient visits, following insurer guidelines.
Verify eligibility for procedures or tests through health care institutions.
Review and audit billing discrepancy reports and research errors for resolution.
Maintain accurate and timely records, logs, charges, files, and other required information.
Perform administrative and clerical duties, including retrieving files and records, faxing, collating, data entry, and relaying messages to physicians, residents, and staff.
Prepare special reports or spreadsheets for physicians as requested.
Comply with departmental policies, procedures, objectives, and health and safety regulations.
Contribute to a respectful environment of professionalism, tolerance, and acceptance toward employees, patients, and visitors.
Perform other duties as required.