Patient Service Representative (PSR) - In Motion Physical Therapy - Town Center

Bon Secours Mercy Health•Virginia Beach, VA

5d•Onsite

About The Position

The Patient Services Representative (PSR) in the In Motion Physical Therapy - Town Center office plays a crucial role in the outpatient rehab setting. This position is responsible for researching and verifying patient health insurance eligibility, interpreting specific insurance benefits for services, and accurately documenting this information within the Electronic Medical Record (EMR) system. The insurance verification specialist also identifies when insurance authorization is required, initiates prior authorization requests, and submits necessary clinical documentation to obtain approval for services provided by the outpatient rehab clinics. This role is essential for ensuring timely billing and reimbursement.

Requirements

High School Diploma or GED (required)
1 year of experience in insurance verification
Comprehensive understanding of insurance eligibility and coverage requirements, contract benefits and medical terminology.

Nice To Haves

None

Responsibilities

Research and verify patient health insurance coverage and eligibility.
Register patient coverage accurately within EMR to ensure timely billing and reimbursement from payer.
Obtain and interpret specific program benefits under patient health insurance plan by using online portals or phone calls to payer.
Concisely and accurately document patient benefit information within EMR system to generate patient estimates.
Effectively communicate benefit information to patients, as needed.
Answer detailed patient questions regarding out of pocket costs, as indicated under their specific insurance plan.
Initiate prior authorization requests with insurance payer, submit clinical documentation that supports medical necessity for request and follow up on authorization status prior to patient’s first scheduled visit.
Maintain clear, timely communication with front office staff regarding insurance benefit barriers that may prevent patient conversion, or delay prior authorization approval prior to first patient visit.
Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.
Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.