Patient Services Specialist
About The Position
Exciting Patient Services Specialist Opportunity! Be the critical link between patients and life-changing care—help veterans and injured workers access the support they need to heal and move forward. At Converge Medical Technology, we provide game-changing technology with empowering personalized patient services as part of our in-home, multidisciplinary programs for chronic low back and neck pain. Our passion is to change people's lives. The genuine care and healing of our patients is our highest mission, and our goal is to help them get back to doing the things they love. Our Patient Services Specialists are the heart of Converge, processing physician orders for workers’ compensation and veteran patients through our verification and authorization process. Their work helps veterans and injured workers access life-changing medical devices that restore mobility and hope. As a Patient Services Specialist, every authorization you process directly impacts a patient’s journey from pain to recovery.
Requirements
- 1+ years of patient intake experience with insurance verification.
- 1-2 years of prior authorization experience in a clinical setting or DME setting.
Responsibilities
- Insurance Verification & Authorization: Verifying insurance benefits and medical documentation for submitting pre-authorization requests to adjusters. Facilitate the processing of prior authorizations, appeals, and insurance updates for prescriptions.
- Serve as a Liaison: Handle a high volume of inbound and outbound calls and manage and respond to incoming referrals from insurance companies, patients, sales representatives and the patient care coordinator team.
- Improve Efficiency: Utilize Salesforce and other internal systems to complete daily tasks in alignment with standard operating procedures. Provide timely, accurate information and guidance to sales representatives, including payer-specific coverage criteria.
- Research & Response: Examine required information using available resources to support referral processing and case updates. Escalate urgent or complex issues to the Intake Manager to ensure timely resolution.
- Perform other duties as assigned.
Benefits
- medical, dental, and vision insurance
- short- & long-term disability
- FSA/ HSA options
- 401k with matching
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
