[Hiring] Patient Service Center Clinical Support Specialist @Indiana Health Centers, Inc.

Role Description

The PSC Clinical Support Specialist is responsible for coordinating patient referrals and managing prior authorizations to ensure timely access to healthcare services. 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.

• Prepare and submit prior authorization 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.
• Coordinate with providers and specialists to schedule referred services.
• Track referral/PA statuses to ensure completion of appointments and continuity of care.
• Communicate referral information and appointment instructions to patients.
• Assist in training new staff for the Patient Service Center.
• Send and follow up on referrals, complete Prior Authorizations (PA), schedule Diagnostic Imaging tests, and other patient care related paperwork.
• Process appropriate patient paperwork in a timely manner.
• Educate patients regarding documents they will need to provide at the time of service.
• Accurately enter, maintain, and retrieve data on IHC’s Electronic Medical Records (EMR) system.
• Communicate appropriate diagnostic and clinical information with patients as needed.
• Communicate with patients care team as necessary.
• May assist with contacting patients for reminder calls and follow-up.

Qualifications

• MA, LPN, or RN (required)
• Lives in the state of Indiana (required)

Requirements

• PSC Clinical Support Specialist is required to be a Medical Assistant (must have completed Medical Assisting degree or certificate program), LPN, or RN (valid Indiana licenses in good standing).
• One (1) year of prior experience in an office or health-related position preferred. Related education can substitute for experience.
• Knowledge of insurance verification and payer authorization processes preferred.
• Spanish fluency preferred.

Benefits

• $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