Medicare Patient Services Specialist

Commence; Virginia Beach (VA); On-site; USD 21,000 - 30,000; Full time

Job summary

Commence is seeking a Patient Service Representative (Clerk III) to inform beneficiaries, triage calls, and manage case intake for Medicare programs. The role supports ISO audits, maintains medical records, and coordinates communications with physicians and providers.

You will work in an office setting, handling confidential information with HIPAA/HITECH compliance, and collaborate across teams to ensure timely service.

Qualifications

• Experience as a call center representative or patient service representative.
• Knowledge of medical terminology and components of medical record documentation.
• Knowledge of CMS, Medicare, and BFCC‑QIO programs.

Responsibilities

• Inform beneficiaries of their rights and responsibilities under Medicare.
• Assist with timely and accurate review processes per contract and QIO manual.
• Act as a neutral liaison for beneficiaries, families, or representatives.
• Inform stakeholders about activities and responsibilities of the QIO and CMS programs.
• Develop and maintain positive relationships with external and internal customers.
• Prepare correspondence to physicians, facilities, and other health organizations.
• Ascertain current contact information and coordinate mailings.
• Process and maintain medical records.
• Track calls and correspondence using electronic systems.
• Enter data into software accurately and timely.
• Participate in quality improvement efforts and issue identification.
• Assist in ISO audit preparations.

Skills

Communication skills

Attention to detail

Interpersonal skills

Problem solving

Medical terminology

CMS familiarity

Ability to work independently

Team collaboration

Data entry

Education

Associate degree in business or health information management

Secretarial school diploma

High school diploma or GED with 4 years experience

Tools

Microsoft Word

Microsoft Excel

Job description

Commence is seeking a Patient Service Representative (Clerk III) to inform beneficiaries, triage calls, and manage case intake for Medicare programs. The role supports ISO audits, maintains medical records, and coordinates communications with physicians and providers.

You will work in an office setting, handling confidential information with HIPAA/HITECH compliance, and collaborate across teams to ensure timely service.