Patient Service Rep

Job Title

Potential Functions:

• Prepare and process work orders accurately and timely
• Obtain, review, and coordinate required documentation, including prescriptions, physician notes, and other supporting records needed to move orders forward
• Verify patient insurance benefits, confirm coverage criteria, and secure prior authorizations or pre-certifications as required
• Ensure data integrity and accuracy of patient account information, including HCPCS and ICD-10 coding, to support proper processing and reimbursement
• Communicate with patients regarding insurance coverage, financial responsibility, and next steps in the process
• Coordinate with physician offices, practitioners, and internal staff to obtain missing information and ensure orders are ready for delivery
• Maintain knowledge of payer-specific rules, documentation requirements, and authorization procedures
• Ensure orders are properly documented and meet company and insurance requirements prior to delivery
• Provide excellent customer service to patients, referral sources, and coworkers
• Document account activity clearly, accurately, and professionally
• Help maintain an efficient flow of service from order intake through readiness for delivery
• Complete other duties as assigned
• Limited travel to nearest office location for support

Skills & Requirements:

• Works independently
• Uses good judgment
• Makes sound decisions
• Communicates professionally with patients, physician offices, insurance representatives, and coworkers
• Works effectively in a fast-paced environment
• Records information clearly, accurately, and concisely
• Handles sensitive and confidential information appropriately
• Meets deadlines, prioritizes tasks, and manages multiple accounts at once
• Proficient in Microsoft Outlook, Word, and Excel
• Organized and detail-oriented
• High school graduate
• Prior experience with insurance verification, prior authorizations, medical documentation, or patient service in a healthcare setting preferred
• Knowledge of anatomy and medical coding is a plus