Patient Service Representative - Prior Authorization- Peoria

Springfield Clinic•Peoria, AZ

About The Position

The Patient Service Representative - Prior Authorization discusses insurance coverage, usual and customary charges, Medicare and Medical Assistance availability, reimbursement options, and the Clinic's billing and credit policies with patients. The role verifies insurance benefits for treatment, secures prior approvals and pre-authorizations, and addresses credit concerns regarding past-due accounts, making special arrangements when necessary to support timely payment. The representative also maintains patient insurance and demographic information, responds to patient questions and requests, maintains statistics, and serves as a resource to providers and staff on insurance and billing issues. The position reports to the Operations Manager or Director of the service line and may provide coverage at other Springfield Clinic locations as assigned.

Requirements

High school graduate or GED.
Ability to handle multiple tasks and prioritize in a fast-paced environment.
Strong verbal communication and listening skills.
Knowledge of computer systems, with emphasis on registration and insurance screens.
Knowledge of Medicare, Medical Assistance, and other third-party payors.
Ability to work courteously and professionally with patients of all ages.
Ability to tactfully work with patients who have past-due accounts.
Ability to meet quality and performance guidelines.
Ability to maintain composure under stress.
Manual dexterity for using a telephone headset, calculator, and computer keyboard.

Nice To Haves

Two to three years of experience in medical billing and insurance.
Computer skills, including Microsoft Office.

Responsibilities

Verify coverage and benefits prior to treatment.
Secure prior approval and pre-authorizations.
Maintain proficiency with insurance and billing issues and serve as a resource to providers and staff.
Provide a positive impression to patients about the Clinic's billing department.
Enter or edit patient insurance coverage and demographic information when necessary.
Answer patients' questions about insurance coverage and other billing issues.
Respond to patients' verbal and written requests in a timely fashion.
Maintain statistics.
Participate in Patient Accounting meetings and training sessions as appropriate.
Work empathetically and responsively with patients while adhering to Patient Accounting billing practices and guidelines.
Provide coverage at other Springfield Clinic locations as assigned.
Comply with Springfield Clinic incident reporting policies and procedures.
Adhere to required OSHA and Springfield Clinic training and accomplishment policies.
Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
Perform other job duties as assigned.