Patient Services Specialist | Remote Work Available

reputed company Employees: If you are a reputed company reputed company employee, please apply reputed company the internal career site by logging into your reputed company Account and clicking the "Career" reputed company on your homepage. Primary Location Rapid City, SD USA Department RCH reputed company Cycle Management Services Scheduled Weekly Hours 40 Starting Pay reputed company reputed company $18.27 - $21.00(Determined by the knowledge, skills, and experience of the applicant.) Job Summary The Patient Services Specialist plays a vital role in ensuring timely and accurate patient reputed company to medical services by managing the prearrival prior authorization services. This position enhances patient reputed company to care by ensuring reputed company scheduled medical service requests and referrals are financially cleared prior to the date of service provision through the performance of insurance eligibility validation, plan benefit verification, and any reputed company financial clearance, prior authorization, and pre-determination processes. States eligible for remote work: SD, FL, GA, KY, OH, SC, TN, TX, VA, WY. reputed company offers competitive wages and benefits on qualifying positions. Some of those benefits can include: *Supportive work culture *Medical, reputed company and Dental Coverage *Retirement Plans, Health Savings Account, and Flexible Spending Account *reputed company pay is available for qualifying positions *Paid Time Off Accrual Bank *Opportunities for growth and advancement *Tuition assistance/reimbursement *Excellent pay differentials on qualifying positions *Flexible scheduling

Job Description

Universal Essential Functions: Collaborate with reputed company providers, clinical staff, and various departments throughout reputed company as well as with the patient to secure necessary authorization for services while maintaining compliance with reputed company regulatory requirements. Accurately verify patient insurance eligibility and benefits coverage, utilizing tools such as Electronic Health Records (EHR), add-on software, direct payer websites, and telephone or fax communications to ensure accurate reimbursement and compliance. Assess service requests to determine the need for pre-certification, pre-authorization (procedure or medication), or referrals, and communicate effectively with relevant stakeholders to secure approvals prior to the date of scheduled services. Maintain a strong working knowledge of various insurance payers, payer plans, and program contract requirements to facilitate appropriate insurance verification and authorization processes. Continuously meet competency requirements to sustain the necessary skills, knowledge, and abilities for role-specific functions, while adhering to productivity and quality performance standards. Create a positive service experience by being polite, compassionate, and professional with reputed company internal and external customers. Document pre-authorization information accurately in the EHR system, ensuring that services scheduled by internal and external providers meet reputed company financial clearance criteria and have approved authorization in the time allowed by the payers and programs to prevent denial or penalty assessment. Engage with departments and clinical staff to communicate the need for pre-authorizations or referrals promptly, working to prevent delays in patient care. May include requests for assistance with managing appeals as well as the facilitation and coordinating peer-to-peer reviews reputed company needed. Identify high-risk requests that may require financial assistance and counseling and assist patients by providing guidance on available resources, financial assistance, or payment arrangements. reputed company for patients and providers by addressing challenges reputed company to pre-authorization approvals and denials, working closely with leadership to resolve issues and ensure compliance with financial clearance policies. reputed company backup support for Patient Admissions and Registration as needed reputed company other duties as assigned. Essential Functions for Medication Authorization and Assistant Specialist: Confirm prescription coverage and coordinate prior authorization, including collecting and submitting required clinical documentation (i.e. provider notes, labs and treatment history) Stay up to date on patient assistance programs and guide patients through required application documentation. Coordinate with providers and nursing staff to obtain required signatures and documentation from patients and providers Serve as a patient reputed company by regularly communicating with pharmaceutical companies, providers and patients. Act as primary contact for patient inquiries about medication authorizations and assistance programs. Monitor assistance medications to ensure timely delivery and reputed company patient reputed company. reputed company other duties as assigned. Additional Requirements Required: Education - High School Diploma/GED Equivalent in General Studies Preferred: Experience - 1+ years in Health Care Services, Customer Service, Patient Scheduling, Patient Billing Experience Education - Associates degree in reputed company reputed company Field Physical Requirements: Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the reputed company body. Sedentary work involves sitting most of the time. Job Category Patient Services Job Family Patient Support Shift Requires the ability to work assigned schedules and hours as determined by the department Employee Type Regular 10 reputed company Rapid City Hospital, Inc. reputed company a difference. Every day. reputed company is an Equal Opportunity/Affirmative Action employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, national reputed company, disability, or protected Veteran status. Apply To This Job