Patient Services Specialist-Authorizations (Family Med/Transmountain)

Position Description

Performs coordinative work in the operation of a specific program or departmental project. Work is performed under general supervision with evaluation based on results obtained. Discusses financial arrangements for all elective surgical procedures based on financial categories with patients in a professional courteous manner with strict adherence to HIP AA policies and guidelines. Verifies insurance benefits and obtains pre-authorizations or referrals for in patient and out-patient services as required by insurance carriers, and assures health plan requirements have been followed. Other related duties as requested by immediate supervisor. Documents the funding and insurance status on all surgical cases in EMR. Provides requested information to facilities, insurance companies and attorneys, etc. in a professional and courteous manner. Discuss deposits and deductibles with patients based on their financial classification for all surgical procedures. Efficiency with all calls streaming in through CXONE phone/call system; avoiding any dropped calls. Documentation of patient information obtained from CXONE into EMR for processing. Scanning and importing eFax into the EMR systems. Correcting and addition of FSCs into the CBIZ system. Due to being remote, PSS will not handle cash.

Preferred Qualifications

• Knowledge in performing insurance verification for all commercial and government plans

• Experience in obtaining insurance authorizations for office and or surgical procedures/ services

• Knowledge of medical terminology, anatomy and physiology preferred

• Education and or experience with insurance verification process and guidelines

• Ability to communicate effectively with patients along with excellent written and oral communication skills

• Ability to work closely and effectively with patients in a professional and courteous manner; working in a fast paced environment

Required Qualifications

• A High School diploma or GED. 1-year Customer Service, office, or related experience

• Additional education may substitute for the experience requirement