Patient Service Representative - Referrals

Overview

Job Summary: The Patient Service Representative - Referrals plays a crucial role in delivering exceptional customer service and ensuring patient satisfaction. This individual will focus on patient education, empowerment, and respect while providing administrative support to maintain quality patient care.

Primary Function: Patient Service Representatives are responsible for completing clinical and administrative tasks to enhance the overall customer experience, with a specific focus on referrals and authorizations.

• Maintain the accuracy of Health Information Records in the Electronic Medical Record system.
• Schedule appointments, perform pre-registration tasks, verify demographic and insurance information, and ensure precise billing.
• Identify the need for clinical healthcare staff triage and coordinate patient flow while upholding patient confidentiality regulations.
• Process Prior Authorizations and Referrals, offer specialist resource information, and keep detailed patient logs.
• Participate in Care Coordination services, contribute to Quality Improvement activities, and engage in patient care teams.
• Attend mandatory meetings and fulfill other assigned duties effectively.

• High School diploma or equivalent.
• Minimum of one year of high-level customer service experience.
• Proficient in insurances, referrals, and prior authorizations.
• Proficiency in Microsoft Office and general computer literacy.

• Associate's Degree in a related field.
• Familiarity with medical terminology.
• Three years of high-level customer service experience.
• Three years of relevant healthcare experience.
• Experience with an Electronic Medical Record system.

This role involves sitting, standing, walking, bending, and occasional lifting up to ten pounds. Work hours may include evenings and weekends, potentially leading to job-related stress.

Salary ranges from $16.93 to $20.24 per hour based on experience.

The position of Patient Service Representative is represented by United Healthcare Workers East, Local 1199.