Patient Services Representative

About the role

The Patient Services Representative (PSR) serves as the first point of contact for patients, healthcare providers, caregivers, and authorized representatives seeking assistance. This role provides accurate information regarding program eligibility, application requirements, and available resources while ensuring timely and compliant documentation processing. The PSR performs structured eligibility review, data entry, and documentation management in accordance with HIPAA, internal policies, and funding requirements.

Responsibilities

• Respond to inbound and outbound calls, emails, and written inquiries regarding program eligibility and application procedures
• Provide accurate information regarding program guidelines, covered and non-covered services, and enrollment processes
• Review, verify, and process eligibility and assistance documentation in accordance with established procedures
• Enter and maintain complete and accurate data in the organization's patient management system
• Initiate follow-up communication when additional documentation or clarification is required
• Verify continued eligibility for active patients in accordance with program requirements
• Identify and correct documentation errors in a timely manner
• Maintain strict confidentiality of patient and organizational information
• Comply with HIPAA privacy requirements and internal compliance standards
• Complete assigned duties within established productivity and quality benchmarks

Requirements

• High school diploma or equivalent required
• 1–3 years of experience in healthcare, call center, benefits coordination, insurance navigation, or related service environment
• Proficiency in Microsoft Office applications and data entry systems
• Basic mathematical ability sufficient to calculate income-based eligibility thresholds
• Ability to communicate clearly in written and verbal formats
• Ability to manage multiple tasks in a structured, high-volume work environment
• Must reside and work within the Commonwealth of Virginia at the time of hire and throughout employment
• Must be authorized to work in the United States
• No visa sponsorship available

Preferred Qualifications

• Associate or bachelor's degree in healthcare, social work, or related field
• Working knowledge of Medicare, Medicaid, Marketplace, and commercial insurance plans

Benefits

• Medical, dental, and vision coverage
• Employer-paid life and disability insurance
• Retirement plan options
• Paid time off and holidays