Patient Services Specialist II - Referrals & Authorization

Patient Services Specialist 2

Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.

Our Core Values are:

• We serve faithfully by doing what's right with a joyful heart.
• We never settle by constantly striving for better.
• We are in it together by supporting one another and those we serve.
• We make an impact by taking initiative and delivering exceptional experience.

The Patient Services Specialist 2 provides administrative help in a physician's office, clinic, or other area. This role ensures high-quality, patient-centered care. Duties include patient relations, check-in or check-out, scheduling, insurance verification, and answering phones. May assist in training and mentoring junior Patient Services Specialists.

Essential Functions of the Role:

• Assists patients and visitors by performing duties like check-in, check-out, scheduling, insurance verification, and answering phone inquiries. Arranges follow-up visits and referral appointments.
• Registers patients by collecting and verifying insurance information. Verifies patient demographics and enters changes into the computer system. Directs patients to appropriate waiting areas.
• Accepts payments for physician or clinic services following guidelines. Posts payments and enters charges using appropriate codes. Generates daily payment reports. Verifies cash drawer against the report. Provides accurate patient, medical, financial, or procedural information to patients or approved entities. Discusses financial arrangements with patients, as requested.
• Responds to routine escalated inquiries concerning services, hours of operation, etc. Ensures any patient complaints are handled appropriately.
• Aids with medical records duties by pulling charts for appointments, prescription refills, and other requests. Retrieves, transports, sorts, and files medical records. Copies medical records charts for patient transfers and referrals as requested.
• Helps in training, mentoring and providing help to junior staff as requested.

Key Success Factors:

• Excellent listening, social, and communication skills, both oral and written. Professional and respectful telephone etiquette. Ability to adjust communication style for different audiences. Caring listener, delicate, upbeat, optimistic, articulate, gracious, and tactful.
• Knowledge of patient registration procedures and documentation.
• Knowledge of medical insurance claims procedures and documentation. Needs to have thorough knowledge of the Out of Network process
• Skilled in the use of personal computers and related software applications.
• Skilled in preparing and maintaining patient records.
• Able to examine unpaid third-party claims and delinquent accounts to resolve appropriate follow-up actions to ensure payment.
• Able to mentor and train staff.
• Strong referral and authorization expertise, with the ability to navigate specialty scheduling and out-of-network requirements.
• Patient-focused team player who thrives in a fast-paced clinic environment and delivers exceptional customer service while managing multiple priorities.
• EPIC proficiency and advanced patient registration experience, including insurance verification and appointment scheduling.

We believe that all people should feel welcomed, valued and supported.

Qualifications:

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - 1 Year of Experience