Patient Service Representative - Referrals

Patient Service Representative - Referrals

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. 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. Responsibilities include maintaining the accuracy of health information records in the electronic medical record system, scheduling appointments, performing pre-registration tasks, verifying demographic and insurance information, and ensuring precise billing. They also identify the need for clinical healthcare staff triage and coordinate patient flow while upholding patient confidentiality regulations. Additionally, they process prior authorizations and referrals, offer specialist resource information, and keep detailed patient logs. Participation in care coordination services, contribution to quality improvement activities, and engagement in patient care teams are also part of the role. Mandatory meetings attendance and fulfillment of other assigned duties effectively are required.

Qualifications include a high school diploma or equivalent, minimum of one year of high-level customer service experience, proficiency in insurances, referrals, and prior authorizations, and proficiency in Microsoft Office and general computer literacy. Preferred qualifications include an 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, and experience with an electronic medical record system.

Physical requirements involve sitting, standing, walking, bending, and occasional lifting up to ten pounds. Work hours may include evenings and weekends, potentially leading to job-related stress. Compensation ranges from $16.93 to $20.24 per hour based on experience. The position is represented by United Healthcare Workers East, Local 1199.