Patient Service Representative - Referrals

**Job Summary:**
The Patient Service Representative - Referrals plays a crucial role in delivering exceptional customer service and ensuring patient satisfaction. This individual focuses on patient education, empowerment, and respect while providing administrative support to maintain quality patient care, with a specific emphasis on referrals and authorizations.

**Primary Function:**
Patient Service Representatives are responsible for completing clinical and administrative tasks to enhance the overall customer experience, specifically focusing on referrals and authorizations.

**Responsibilities:**
- Maintain the accuracy of Health Information Records in the Electronic Medical Record system.
- Schedule appointments, perform pre-registration tasks, verify demographic and insurance information, and ensure precise billing.
- Identify the need for clinical healthcare staff triage and coordinate patient flow while upholding patient confidentiality regulations.
- Process Prior Authorizations and Referrals, offer specialist resource information, and keep detailed patient logs.
- Participate in Care Coordination services, contribute to Quality Improvement activities, and engage in patient care teams.
- Attend mandatory meetings and fulfill other assigned duties effectively.

**Qualifications:**
- High School diploma or equivalent.
- Minimum of one year of high-level customer service experience.
- Proficient in insurances, referrals, and prior authorizations.
- Proficiency in Microsoft Office and general computer literacy.

**Preferred Qualifications:**
- Associate's Degree in a related field.
- Familiarity with medical terminology.
- Three years of high-level customer service experience.
- Three years of relevant healthcare experience.
- Experience with an Electronic Medical Record system.

**Physical Requirements:**
This role involves sitting, standing, walking, bending, and occasional lifting up to ten pounds. Work hours may include evenings and weekends, potentially leading to job-related stress.

**Compensation:**
Salary ranges from $16.93 to $20.24 per hour based on experience.

**Union Affiliation:**
The position of Patient Service Representative is represented by United Healthcare Workers East, Local 1199.