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

Bon Secours Mercy HealthVirginia Beach, VA
Onsite

About The Position

As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive. Patient Services Representative outpatient rehab office staff by researching and verifying patient health insurance eligibility, interpreting insurance benefits for a specific service, and documenting this information into EMR system. Insurance verification specialist identifies when insurance authorization is required, initiates prior authorization request, and submits supporting clinical documentation to obtain approval for services provided by outpatient rehab clinics.

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.

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.

Benefits

  • Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
  • Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts
  • Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
  • Tuition assistance, professional development and continuing education support
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