Patient Services Rep

About the role

Our Patient Service Representatives are an important part of creating a seamless patient experience. As a Patient Service Representative (PSR) with a Prior Authorization Focus, you'll play a key role in helping patients access the care they need by managing and coordinating insurance authorizations for medical services, procedures, imaging, referrals, and medications. You'll work closely with providers, clinical teams, insurance carriers, and patients to ensure authorization requirements are met, documentation is complete, and approvals are obtained in a timely manner. If you're organized, detail-oriented, and comfortable navigating insurance requirements, this role offers the opportunity to make a direct impact by helping prevent delays in patient care and keeping the patient journey moving forward.

Responsibilities

As a Patient Service Representative (PSR), a typical day might include the following:

• Initiating, submitting, and tracking prior authorization requests for procedures, diagnostic testing, referrals, and medications
• Reviewing provider orders and clinical documentation to ensure information is complete and accurate before submitting authorization requests
• Communicating with insurance carriers regarding authorization approvals, denials, and requests for additional information
• Following up on pending authorizations to help ensure timely resolution and prevent delays in patient care
• Accurately documenting authorization status, reference numbers, outcomes, and supporting information in the electronic medical record (EMR)
• Notifying providers and clinical staff of authorization determinations and any required next steps
• Assisting with peer-to-peer review coordination when required by insurance plans
• Verifying insurance eligibility and benefits related to prior authorization requirements
• Educating patients about authorization status, expected timelines, and insurance requirements as needed
• Coordinating scheduling of services once authorization approval is obtained
• Maintaining organized records of authorization requests and supporting documentation
• Collaborating with front desk, clinical, and billing teams to support continuity of care
• Identifying authorization trends, delays, or denials and escalating issues appropriately

Qualifications

The Patient Service Representative (PSR) role might be for you if:

• You enjoy helping patients navigate the healthcare and insurance process and understand the importance of timely access to care
• You are highly organized and comfortable managing multiple authorization requests, deadlines, and follow-ups
• You have strong attention to detail and understand the importance of accurate documentation
• You communicate confidently and professionally with patients, providers, clinical teams, and insurance carriers
• You are persistent and proactive when following up on pending authorizations or resolving issues
• You can review information carefully, identify missing documentation, and determine when an issue needs to be escalated
• You work well independently while collaborating closely with providers, clinical staff, front desk teams, and billing
• You value confidentiality, accuracy, and delivering a positive patient experience

Requirements

• High School Diploma or General Education Degree (GED)
• Minimum of 3 years of relevant experience and/or training
• Background in revenue cycle
• Clear understanding of the importance of patient satisfaction and safety
• Strong oral and written communication skills

Preferred qualifications

• Prior Authorization Certification Specialist (PACS) Certification
• Neurology/Neurosurgery experience

Schedule

Day shift, Monday through Friday 8:30am-5:00pm, Full-Time, 40 hours per week

Pay

$21.07 - $26.22 per hour

Benefits

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more