What are the responsibilities and job description for the Patient Service Representative (PSR) - InMotion Harbour View position at Bon Secours Mercy Health?
At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.
Summary Of Primary Function/General Purpose Of Position
The Insurance Verification Specialist supports outpatient rehab office staff by researching and verifying patient health insurance eligibility, interpreting insurance benefits for a specific service, and documenting this information into EMR system. Insurance verification specialist identifies when insurance authorization is required, initiates prior authorization request, and submits supporting clinical documentation to obtain approval for services provided by outpatient rehab clinics.
Essential Functions - List the essential functions of the job. Essential functions are the reasons a job exists.
Working in office full time position.
Research and verify patient health insurance coverage and eligibility. Register patient coverage accurately within EMR to ensure timely billing and reimbursement from payer
Obtain and interpret specific program benefits under patient health insurance plan by using online portals or phone calls to payer
Concisely and accurately document patient benefit information within EMR system to generate patient estimates
Effectively communicate benefit information to patients, as needed. Answer detailed patient questions regarding out-of-pocket costs, as indicated under their specific insurance plan
Initiate prior authorization requests with insurance payer, submit clinical documentation that supports medical necessity for request and follow up on authorization status prior to patient’s first scheduled visit
Maintain clear, timely communication with front office staff regarding insurance benefit barriers that may prevent patient conversion, or delay prior authorization approval prior to first patient visit
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.
Employment Qualifications
Education Qualifications - List the minimum education, training, and experience required to perform the essential functions of the position.
Required Minimum Education:
High School Diploma or GED
Minimum Years and Type of Experience:
1 year of experience in insurance verification
Other Knowledge, Skills and Abilities Required:
Comprehensive understanding of insurance eligibility and coverage requirements, contract benefits and medical terminology. Customer focused with strong interpersonal skills, courtesy and tact with patient and rehabilitation staff. Work requires the ability to ensure the confidentiality and rights of patients and the confidentiality of hospital and departmental documents. Must be able to demonstrate a working knowledge of personal computers and proficient in computer applications and other electronic technologies. Must demonstrate a positive and professional demeanor along with strong verbal and written communication skills, including proper phone etiquette. Understand and follow HIPAA regulations. Able to organize workload and manage time efficiently. Must be able to handle potentially stressful situations and multiple tasks simultaneously. Must be able to successfully complete additional job related training when offered.
Many of our opportunities reward* your hard work with:
Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more
Summary Of Primary Function/General Purpose Of Position
The Insurance Verification Specialist supports outpatient rehab office staff by researching and verifying patient health insurance eligibility, interpreting insurance benefits for a specific service, and documenting this information into EMR system. Insurance verification specialist identifies when insurance authorization is required, initiates prior authorization request, and submits supporting clinical documentation to obtain approval for services provided by outpatient rehab clinics.
Essential Functions - List the essential functions of the job. Essential functions are the reasons a job exists.
Working in office full time position.
Research and verify patient health insurance coverage and eligibility. Register patient coverage accurately within EMR to ensure timely billing and reimbursement from payer
Obtain and interpret specific program benefits under patient health insurance plan by using online portals or phone calls to payer
Concisely and accurately document patient benefit information within EMR system to generate patient estimates
Effectively communicate benefit information to patients, as needed. Answer detailed patient questions regarding out-of-pocket costs, as indicated under their specific insurance plan
Initiate prior authorization requests with insurance payer, submit clinical documentation that supports medical necessity for request and follow up on authorization status prior to patient’s first scheduled visit
Maintain clear, timely communication with front office staff regarding insurance benefit barriers that may prevent patient conversion, or delay prior authorization approval prior to first patient visit
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.
Employment Qualifications
Education Qualifications - List the minimum education, training, and experience required to perform the essential functions of the position.
Required Minimum Education:
High School Diploma or GED
Minimum Years and Type of Experience:
1 year of experience in insurance verification
Other Knowledge, Skills and Abilities Required:
Comprehensive understanding of insurance eligibility and coverage requirements, contract benefits and medical terminology. Customer focused with strong interpersonal skills, courtesy and tact with patient and rehabilitation staff. Work requires the ability to ensure the confidentiality and rights of patients and the confidentiality of hospital and departmental documents. Must be able to demonstrate a working knowledge of personal computers and proficient in computer applications and other electronic technologies. Must demonstrate a positive and professional demeanor along with strong verbal and written communication skills, including proper phone etiquette. Understand and follow HIPAA regulations. Able to organize workload and manage time efficiently. Must be able to handle potentially stressful situations and multiple tasks simultaneously. Must be able to successfully complete additional job related training when offered.
Many of our opportunities reward* your hard work with:
Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more
- Benefits offerings vary according to employment status
