Ambulatory Services Representative III-U

Coordinates all functions and activities related to patient access, including operation room (O.R.) scheduling, front-end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, and administrative duties in support of the department.

Responsibilities

• Primarily responsible for surgical scheduling for all departmental cases, including all pre-op appointments and other applicable procedure scheduling.
• Processes prior authorization and pre-certification work lists and reconciliations for operative cases (elective, urgent, and emergent).
• Coordinates medical clearance documentation.
• Manages physician O.R. calendars.
• Manages O.R. block time and ensures utilization is maximized.
• Cancels blocks within 30 days.
• Notifies Pre-Surgical Services of changes in physicians or patients' schedules.
• Performs administrative duties to ensure proper functioning of the department, including:
  • Reception and customer service
  • Creating or verifying Master Patient Index (MPI)
  • Registration demographics and visit management
  • Appointment scheduling (including consults, tests, in-office procedures, follow-up visits, and cross-booking interpreters, social services, radiology, etc.)
  • Insurance/coverage verification
  • Co-payment collection
  • Front-end review and correcting registration and insurance edits
  • Pre-authorization, referral coordination, and referral reconciliation
  • Referral work lists
  • Billing charge entry and batch controls
  • Billing (TES) edits and hold bill edits
  • Charge reconciliations
  • Billing and managed care functions
• Provides physician and departmental support, such as managing physician and manager calendars, scheduling administrative appointments, handling or routing calls, and verifying credentialing documents.
• Provides general administrative support, including word processing, spreadsheets, and presentation software to create and edit department documents and presentations; handling forms, phones, filing, and making appointments.

Requirements

• Bachelor's degree plus 1-2 years of relevant work experience, or
• Associate's degree plus at least 3 years of relevant experience, or
• High school diploma/GED with 5+ years of relevant experience.

Skills

• Excellent English communication skills (oral and written) and interpersonal skills to interact courteously and effectively with internal and external contacts.
• Demonstrated customer service skills, including the ability to use appropriate judgment, independent thinking, and creativity when resolving customer issues.
• Ability to maintain strict confidentiality of all personal/health-sensitive information.
• Ability to handle challenging situations and balance multiple priorities.
• Strong computer skills and knowledge of Microsoft Office applications (Word, Excel, Access, PowerPoint) and web/internet.
• Experience with standard hospital registration and billing systems or ability to learn such systems.

Pay

Compensation range: $24.86–$30.30 per hour. This range is based on minimum job qualifications. Actual base pay considers education, experience, and licensure/certifications directly related to the role.

Benefits

• Medical, dental, vision, and pharmacy benefits
• Contract increases
• Flexible Spending Accounts
• 403(b) savings matches
• Earned time cash out
• Paid time off
• Career advancement opportunities
• Resources to support employee and family well-being

Schedule

Full Time