Patient Care Specialist II

Patient Care Specialist II

The Patient Care Specialist II performs advanced administrative and patient access duties to support daily medical office operations. This role is responsible for independently registering patients, verifying insurance, processing referrals, and resolving basic billing or documentation issues. The Specialist II ensures all interactions comply with HIPAA, privacy, and organizational policies while consistently providing exceptional service to patients, families, and staff.

Responsibilities

Greets, registers, and checks in patients, ensuring all demographic, insurance, consent, and contact information is accurate and current in the EHR.

Collects and processes copayments following standard cash-handling and reconciliation procedures.

Verifies insurance eligibility, obtains required authorizations, and documents verification results accurately in the patient record.

Provides clear explanations of check-in processes, insurance requirements, and payment expectations.

Answers and routes phone calls, schedules or reschedules appointments, and maintains daily appointment schedules while communicating adjustments to clinical staff.

Processes urgent specialist referrals, appointment ticklers, and medical record release requests in a timely and accurate manner.

Performs clerical and administrative tasks including filing, faxing, scanning, and uploading documents into the EHR.

Reviews patient accounts for outstanding balances or documentation errors and partners with billing to resolve discrepancies.

Maintains full HIPAA and privacy compliance by safeguarding patient information, properly managing documentation, and limiting access to authorized users only.

Identifies and reports potential privacy breaches, compliance risks, or billing concerns promptly according to established protocols.

Prepares, routes, and manages medical documentation to ensure completeness, confidentiality, and accuracy.

Provides professional, courteous customer service and maintains composure during high-volume or challenging situations.

Coordinates scheduling across multiple providers, departments, or specialties to support efficient patient flow.

Audits patient charts, registration data, and referral documentation to identify and correct compliance or process issues.

Participates in mandatory training programs related to compliance, privacy, workflow changes, and patient experience.

Supports the Practice Manager and care team with assigned administrative tasks.

Participates in departmental audits, workflow redesign initiatives, and implementation of new systems or technologies.

Prepares and distributes operational reports related to scheduling efficiency, registration accuracy, or service metrics.

Demonstrates excellent guest service to internal team members and patients.

Performs other related duties as assigned.

Qualifications

High school diploma or GED required.

2+ years of progressive experience in a healthcare or patient access environment.

Strong working knowledge of EHR systems, insurance verification, and medical terminology.

Strong attention to detail, interpersonal communication, and time-management skills.

Demonstrated professionalism and commitment to patient confidentiality.

Demonstrates empathy and professionalism when interacting with patients and families.

Adheres to HIPAA and privacy standards in all communications and record handling.

Consistently meets expectations, follows direction, and maintains punctuality.

Adjusts to changing workflows and patient volume with composure and teamwork.

Demonstrated ability to manage multiple priorities while maintaining accuracy.

Proven commitment to maintaining confidentiality, accuracy, and professional ethics.

Ability to work independently in a fast-paced, cross-functional environment.