Patient Services Representative

Talentify; Stroudsburg (Monroe County); On-site; USD 32,000 - 42,000; Full time

Job summary

Good Shepherd is seeking an Administrative Insurance Coordinator to support clinicians by handling information management, scheduling patient visits, verifying insurance coverage, and guiding patients through benefits and costs. You will use Cerner EMR, collect copays, and resolve questions on coverage while maintaining confidentiality.

The role emphasizes excellent communication, accurate data entry, and teamwork in a busy office environment.

Qualifications

• Education: High School Diploma required; Associate's Degree preferred.
• 1-2 years of experience in an administrative position with computer skills required.
• Prior health insurance experience preferred.
• Basic Life Support / CPR preferred.

Responsibilities

• Answer and triage phone calls and schedule patient visits.
• Verify and secure insurance coverage for therapy services.
• Collect copays and communicate benefits and potential financial responsibility to patients.
• Maintain and use Cerner EMR system for documentation and authorization tracking.
• Assist with patient inquiries regarding insurance and authorizations.

Skills

Interpersonal communication

Scheduling

Teamwork

Education

High School Diploma

Associate's Degree preferred

Tools

Cerner

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