Patient Services Specialist

Position Description

This position is responsible for ensuring the smooth operation of the clinic patient flow and serving as the primary contact for patients. Responsible for scheduling appointments, preparing necessary paperwork before the patient visits, receiving patients, and maintaining records. In addition, this position is responsible for processing charges for clinic services, filing insurance claims, responding to requests for information from patients and insurance companies and maintaining related information for the department. Employees may have cash-handling responsibilities.

Major/Essential Functions

• Be a part of a referral management team within the department of pediatrics.
• Coordinate completion of referrals from receiving order to scheduling the first appointment, then confirming the appointment was completed.
• Document and update status within the referral management tool.
• Answer the department of pediatrics referral line calls.
• Remain professional when communicating with patients and all team members.
• Communicate with patients and their guardians regarding the status of insurance before authorizations. Keeping patients informed that if prior approval is not completed, they will be charged the self-pay rate at the visit.
• Run eligibility on all patients scheduled by the referral team, and others as assigned.
• Run patient estimates on all self-pay patients scheduled by the referral team, and others as assigned.
• Send first appointment letters with instructions regarding appointment and no-show policy.
• Communicate the status of PA with PCP to expedite completion.

Required Qualifications

A High School diploma or GED. 1-year Customer Service, office, or related experience. Additional education may substitute for the experience requirement.

Preferred Qualifications

At least 1 year in previous manage care / referral coordinator roles. Spanish speaking.