PATIENT SERVICES REPRESENTATIVE - (Authorizations, Verification & Referrals)

Salience TMS Neuro Solutions•Plano, TX

4h•$21 - $23•Onsite

About The Position

The Patient Services Representative provides support for patients, providers, and patient services departments. The representative will assist with and be responsible for duties that include, but not limited to, insurance verification, prior authorizations for procedures and medications, coordinating incoming and outgoing referrals. This position is 100% on-site in our central support office in Plano.

Requirements

High School Diploma or equivalent.
Two plus (2+) years of experience obtaining insurance verifications and prior authorizations.
Two plus (2+) years of medical accounts receivable.
Knowledge of reimbursement processes, and payer guidelines.
Experience working within an electronic medical record (EMR) or practice management system.

Nice To Haves

Experience using Athenahealth or similar electronic medical record software.
Experience in Psychiatry, Neurology, Behavioral Health, or Primary Care.
Knowledge of ICD-10, CPT, and HCPCS coding.
Bilingual (English/Spanish) is a plus.

Responsibilities

Verify patient insurance eligibility and benefits for Psychiatry, Neurology, and Primary Care services using electronic eligibility systems and direct communication with insurance carriers.
Obtain and manage prior authorizations for procedures, diagnostic services, and medications, including submitting requests, monitoring status, and coordinating appeals when necessary.
Coordinate incoming and outgoing patient referrals with internal providers and external healthcare organizations to support continuity of patient care.
Research, identify, and resolve insurance, billing, payment, and authorization issues to facilitate timely reimbursement.
Request, receive, process, and securely transmit patient medical records in accordance with HIPAA, company policies, and regulatory requirements.
Receive, distribute, and process incoming correspondence, including electronic and faxed documentation, ensuring timely routing to appropriate departments.
Respond professionally to inquiries from patients, insurance companies, providers, and internal staff regarding insurance coverage, billing, referrals, authorizations, medical records, and account status.
Accurately document all patient account activity, communications, referrals, authorizations, and claim updates within the electronic medical record and other applicable systems.
Prioritize and manage multiple assignments while meeting departmental productivity, quality, and service expectations in a fast-paced environment.
Maintain confidentiality of patient, employee, and company information while complying with HIPAA, privacy regulations, and organizational policies.
Collaborate effectively with providers, clinic staff, billing personnel, and other departments to ensure efficient patient service and revenue cycle operations.
Perform other duties as assigned.