Patient Services Representative

Talentify; Kutztown (Berks County); On-site; USD 36,000 - 48,000; Full time

Job summary

Good Shepherd is seeking an administrative specialist to support clinicians by managing information flows, scheduling patient visits, and verifying insurance coverage for therapy services.

You will triage calls, document using the EMR system, and communicate benefits and expected patient responsibilities to ensure smooth care delivery.

Qualifications

• Education: High School Diploma required; Associate's Degree preferred.
• Work Experience: 1–2 years in an administrative role with computer skills.
• Licenses/Certifications: BLS/CPR preferred for healthcare settings.

Responsibilities

• Answers and triages phone calls from patients and referrals.
• Schedules initial and follow-up patient visits.
• Verifies and secures insurance coverage for therapy services.
• Communicates insurance benefits and patient financial responsibility.
• Collects copays and tracks payments; handles authorizations and referrals.

Skills

Interpersonal communication

Scheduling visits

Phone triage

Customer service

EMR system

Education

High School Diploma

Associate's Degree

Tools

Cerner EMR

Job description

• JOB SUMMARY

  • Enhances clinicians’ effectiveness by providing information management support, which includes answering and triaging phone calls, scheduling patients visits, verifying and securing both initial and ongoing insurance coverage for therapy services, and providing patients with relevant information concerning their insurance coverage.

• ESSENTIAL FUNCTIONS

  • Office Skills

    • Demonstrates excellent interpersonal communication skills that translate across the phone, e-mail and in person.
    • Effectively and efficiently schedules patients’ initial and follow up visits as needed.
    • Greets patients & visitors; Registers patients.
    • Assists with answering & triaging referral telephone calls; demonstrates the ability to understand and differentiate between the different types of therapy.
    • Utilizes patient EMR system
    • Collects and verifies insurance information for new and existing patients who have a change in insurance during course of care.
      • Attains correct insurance benefit information from insurers.
      • Communicates benefits, and potential financial responsibility to patients.
      • Collects patient copays at time of service and consolidates payments on a weekly/daily basis based on location.
      • Follows up with patients who have out-of-pocket costs.
      • Communicates with and resolves patient questions regarding insurance and benefits.
    • Obtains authorization for necessary services from insurers for patient
      • Performs accurate and timely maintenance of authorization functions, referrals and visit limit tracking in Cerner.
      • Prevents disruption of service by securing necessary authorizations prior to the end date after consulting with therapist.
      • Answers patient calls regarding authorization questions.
      • Researches denials due to authorization or referral issues to determine cause and resolution; resubmits claims after gathering necessary information.
    • Assists in obtaining patient satisfaction surveys
    • Performs other duties as requested

  • Documentation

    • Accurately utilizes patient EMR system
    • Accurately copies record when requested
    • Accurately tracks the need for insurance reauthorizations for patients

  • Team Effort

    • Identifies work unit issues & implements solutions
    • Orients new staff
    • Demonstrates flexibility to help others (provide coverage, adjust work schedule to meet needs)
    • Shares knowledge with others
    • Embraces change and promotes a positive work environment
    • Demonstrates management skills by prioritizing, organizing and completing job responsibilities.

  • PROTECTS CUSTOMER AND ORGANIZATION INFROMATION

    • By keeping information confidential, following Good Shepherd’s policy and procedures for release of information, maintaining secure medical records and maintaining security for the contents of the business office.

• QUALIFICATIONS:

  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    • Education
      • High School Diploma required
      • Associate's Degree preferred
    • Work Experience
      • 1-2 years of experience in an administrative position with computer skills required
      • Prior health insurance experience preferred
    • Licenses / Certifications
      • Basic Life Support / CPR, as a healthcare provider, per the American Heart Association preferred