Ambulatory Service Representative III- Weight Loss Surgery

POSITION SUMMARY:

The incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: operation room (O.R.) scheduling, front end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, and a variety of administrative duties in support of department (such as coordination of physician credentialing, handling forms, phones, filing, making appointments, photocopying, faxing, mailings, letters, reports, etc).

Position: Ambulatory Service Representative III- Weight Loss Surgery

Department: Bariatric Surgery

Schedule: Full Time

ESSENTIAL DUTIES/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 OR calendars.
• Manages OR block time and ensures utilization is maximized.
• Cancels blocks within 30 days.
• Notifies Pre-Surgical Services of changes in physicians or patients’ schedules.

In addition, performs a wide variety of administrative duties to ensure proper functioning of assigned department, including, but not limited to:

• Reception & customer service
• creating or verifying Episodes of Care
• registration demographics
• visit management
• appointment scheduling (including consults, tests, in-office procedures, follow-up visits and cross-booking interpreters, social services, radiology, etc.)
• Bariatric Program Enrollment
• insurance/coverage verification
• co-payment collection
• front-end review and correcting registration & insurance edits pre-authorization, referral coordination and referral reconciliation
• Referral work lists
• Billing charge entry
• o Batch controls
• o Billing (TES) edits
• o Hold bill edits
• o Charge reconciliations
• billing and managed care functions
• Provides physician and departmental support such as managing physician & manager calendars, schedule physician & managers’ administrative appointments, handles or routes calls to the department, verifies credentialing documents, etc.
• Provides general administrative support to include, word processing, spreadsheets, presentation software to create and edit department documents and presentations; handling forms, phones, filing, making appointments, photocopying, faxing, mailings, etc.
• Other relevant duties as needed.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

• Bachelor’s degree plus 1 – 2 years relevant work experience or
• Associates degree plus at least 3 years relevant experience or
• HS/GED with 5+ years relevant experience.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

• None

EXPERIENCE:

• See "Education"

KNOWLEDGE & SKILLS:

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

Equal Opportunity Employer/Disabled/Veterans