Ambulatory Service Rep III - The Woodlands

Join Kelsey-Seybold Clinic

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

Performs detailed job requirements of a financial reviewer, patient service representative, PBX operator, appointments clerk and/or medical records clerk. Performs other duties as assigned by the site manager.

Primary Responsibilities:

• Financial Reviewer: Performs detailed financial review including; reviewing patient notes. Determining payment source. Determining insurance eligibility and documenting information received by touch-tone and e-verification eligibility, fax and /or personal contact with insurance company. Reviewing outstanding balances, analyzing the reason for balance and communicating their findings, as needed, to the patient. Reporting discrepancies to the Patient Account Department or Central Business Office for correction. Utilizing good interpersonal skills when financially counseling patients regarding balances. Reviewing account notes
• Documenting accounts to be collected at the time of service in EPIC, including outstanding balances, deductible status, and co-insurance/co-pay amounts to be collected. Documents corporate billing information in EPIC. Support the clinical practice by focusing on billing and managed care functions (including charge entries, billing edits (work queues), charge reconciliations, responding to billing inquires, corresponding with insurance carriers, investigating billing discrepancies, etc.) May also support the clinic with front-end customer service, patient registration, insurance/coverage verification, patient check in/check out processes
• Ambulatory Service Representative: Provides assistance to patients so that the patient can be processed quickly and efficiently and to ensure that accurate information is obtained and conveyed to the patient including: relaying information regarding wait time to patients. Answering questions and provides assistance to patients either directly or by referring them to the appropriate person/department. Assisting with filling out forms and paperwork required by the clinic. Updating patient demographics and insurance information in Epic. Obtaining necessary corporate accounts/Worker's Compensation information and ensure proper billing and reporting, including printout of account information and employer instructions. Processes check-in and check-out in Epic system allowing for immediate charge entry into the accounts receivable system. Requires knowledge of all POS functions. Collects appropriate fees, co-pays, deductibles and con-insurance amounts as determined and documented by the financial review personnel. Issues receipts for all monies received
• Performs cash control procedures for daily accounting of opening cash and balancing of ending cash. Performs reconciliation procedures on POS system within 48 hours of date of service, ensuring that accurate charge capture and all revenue generating patient encounters have been closed. Processes registration of new patients including name search, pseudo number conversion and account set up with insurance, demographic information and scans insurance card into Epic
• PBX Operator: Answers, screens and directs incoming calls according to PBX standards and procedures. Provides assistance to patients so that patient inquiries can be processed quickly and efficiently to ensure that accurate information is obtained and conveyed to the patient including: referring patients to appropriate departments, relaying information regarding phone wait times, answering questions and providing assistance either directly or by referring them to the appropriate person/department. Reports internal and external complaints to Coordinator, Supervisor or Clinic Administrator in a timely manner. Activates and cancels call forwarding to/from the Contact Center at the scheduled times. Takes messages as needed in a complete, concise manner with all required information. Maintains an updated list of all physicians, departmental and internal extensions
• Appointment Clerk: Schedules appointments in the computer system following clinic standards and procedures. Schedules ancillary appointments providing instructions and preps when necessary. Confirms future appointments one day in advance of appointment or as directed by site management
• Medical Records Clerk: Retrieves and routes all incoming/requested medical records and files back or forwards upon return according to established clinic standards. Receives and forwards patient records in the computer for tracking purposes. Prioritizes record requests according to established clinic standards. Follows policy and procedure regarding patient confidentiality. Performs regular internal transportation runs as specified by manager. Forwards to ROI with appropriate authorization
• Other duties as assigned by site management

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School diploma or GED from an accredited program
• 2+ years of medical office experience to include the following: face to face customer service, cash handling, patient registration, appt. scheduling, medical billing, & experience in answering a multi-line telephone system. or 1+ years KSC Experience as an Ambulatory Service Representative II
• EMR experience MS Word and Excel
• Familiarity with medical terminology, Excellent customer service skills in person and over the telephone
• Fluent in English, verbal and written
• Professional demeanor and appearance

Preferred Qualifications:

• 3+ years of experience working in a physician, hospital, or medical office environment
• 2+ years of insurance/managed care experience, to include insurance verification, being able to identify, communicate/articulate and understand the difference between insurance plans (HMO, PPO, EPO, etc.)
• Epic experience
• Solid computer skills and knowledge of Microsoft Office applications (MS Word, Excel, and PowerPoint) and web/Internet
• 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 effectively handle challenging situations and to balance multiple priorities
• Bilingual- English and Spanish communication skills (oral and written) possesses the interpersonal skills which are required to interact with internal and external contacts in a courteous and patient focused manner

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.