Patient Service Center Clinical Support Specialist - Remote in Indiana

The IHC Corporate team is now recruiting for a remote Patient Service Center (PSC) Clinical Support Specialist living in the state of Indiana.

About the role

This role serves as a liaison between patients, providers, insurance companies, and specialty clinics to facilitate efficient care coordination. The specialist ensures all referrals and/or authorization documentation is complete, accurate, and compliant with payer requirements.

Responsibilities

• Prepare and submit prior authorization of requests for procedures, medications, imaging, and specialty services.
• Collect and compile required clinical documentation to support authorization requests.
• Communicate with insurance companies to obtain approval, provide additional information, or resolve authorization issues.
• Monitor authorization status and follow up on pending requests to prevent delays in care.
• Document authorization numbers, approvals, denials, and expiration dates in the EHR.
• Process incoming and/or outgoing patient referrals to specialty providers, diagnostic services, and ancillary care.
• Verify referral/PA requirements based on insurance guidelines and payer policies.
• Cook up with providers and specialists to schedule referred services.
• Track referral/PAs statuses to ensure completion of appointments and continuity of care.
• Communicate referral information and appointment instructions to patients.
• Aid in training new staff for the Patient Service Center.
• Sending and following up on referrals, completing Prior Authorizations (PA), Scheduling Diagnostic Imaging tests, and other patient care related paperwork.
• Processes appropriate patient paperwork in a timely manner.
• Educate patients regarding documents they will need to provide at the time of service.
• Accurately enters, maintains, and retrieves data on IHC’s Electronic Medical Records (EMR) system.
• Communicates appropriate diagnostic and clinical information with patients as needed.
• Communicates with patients care team as necessary.
• Might assist with contacting patients for reminder calls and follow-up.

Requirements

• Medical Assistant (must have completed Medical Assisting degree or certificate program), LPN, or RN (valid Indiana licenses in good standing).
• Lives in the state of Indiana (required).
• Knowledge and experience with both Medication and Imaging Prior Authorizations.
• Experience with referrals to specialists.
• Document management experience.
• One (1) year of prior experience in an office or health-related position preferred.
• Knowledge of insurance verification and payer authorization processes preferred.

Qualifications

• MA, LPN, or RN (required).

Skills

• Great communication skills, both verbal and written.
• Knowledge of ICD-10 codes and meanings.

Benefits & Compensation

• $1000.00 retention bonus paid after one year.
• No nights or weekends.
• Generous Paid Time Off and Floating Holidays.
• Day 1 Insurance benefits eligibility.
• 403(b) Retirement Plan matching at one year of employment.
• Employer-paid Group Life, Short-term disability, and Long-term disability coverages and HSA employer contributions.
• Flexible Leave of Absence programs.
• Personify Health Wellness program with paid incentives for participation.
• Employee Assistance Programs with 24/7 access to therapy consultation services.