Ambulatory Service Representative - Pedi High Risk

Description Summary : Performs a variety of complex administrative duties for patients in need of routine and / or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in / outpatient setting. Assess patients’ needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities : Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician’s clinical staff, as well as 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 physician Greets patients for scheduled and / or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient / guardian for treatment authorization and insurance / billing information Collaborates with insurers to obtain patients’ prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and researches errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements : High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills 1+ year of customer service experience required Experience with medical office terminology preferred Work Schedule : 8AM - 5PM Monday-Friday Work Type : Full Time