Patient Services Specialist | 5th St Clinic at Monument Health

Current Employees

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage. Primary Location Rapid City, SD USA Department MHMC-RC 5th St. Clinic Management Scheduled Weekly Hours 40 Starting Pay Rate Range $18.27 - $21.00 (Determined by the knowledge, skills, and experience of the applicant.) Job Summary The Patient Services Specialist plays a vital role in ensuring timely and accurate patient access to medical services by managing the prearrival prior authorization services.

This position enhances patient access to care by ensuring all scheduled medical service requests and referrals are financially cleared prior to the date of service provision through the performance of insurance eligibility validation, plan benefit verification, and any related financial clearance, prior authorization, and pre-determination processes. Monument Health offers competitive wages and

Benefits

• on qualifying positions. Some of those

Benefits

• Can Include: *Supportive work culture *Medical, Vision and Dental Coverage *Retirement Plans, Health Savings Account, and Flexible Spending Account *Instant pay is available for qualifying positions *Paid Time Off Accrual Bank *Opportunities for growth and advancement *Tuition assistance/reimbursement *Excellent pay differentials on qualifying positions *Flexible scheduling
• Job Description Universal Essential Functions: Collaborate with healthcare providers, clinical staff, and various departments throughout Monument Health as well as with the patient to secure necessary authorization for services while maintaining compliance with all regulatory requirements. Accurately verify patient insurance eligibility and

Benefits

coverage, utilizing tools such as Electronic Health Records (EHR), add-on software, direct payer websites, and telephone or fax communications to ensure accurate reimbursement and compliance. Assess service requests to determine the need for pre-certification, pre-authorization (procedure or medication), or referrals, and communicate effectively with relevant stakeholders to secure approvals prior to the date of scheduled services. Maintain a strong working knowledge of various insurance payers, payer plans, and program contract requirements to facilitate appropriate insurance verification and authorization processes.

Continuously meet competency requirements to sustain the necessary skills, knowledge, and abilities for role-specific functions, while adhering to productivity and quality performance standards. Create a positive service experience by being polite, compassionate, and professional with all internal and external customers. Document pre-authorization information accurately in the EHR system, ensuring that services scheduled by internal and external providers meet all financial clearance criteria and have approved authorization in the time allowed by the payers and programs to prevent denial or penalty assessment.

• Additional Requirements Required: Education - High School Diploma/GED Equivalent in
• General Studies Preferred: Experience - 1+ years in Health Care Services, Customer Service, Patient Scheduling, Patient Billing Experience Education - Associates degree in Healthcare Related Field

Physical Requirements

• Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body.
• Sedentary work involves sitting most of the time.
• Job Category Patient Services Job Family Patient Support Shift Requires the ability to work assigned schedules and hours as determined by the department Employee Type Regular 10 Monument Health Rapid City Hospital, Inc.
• Make a difference .
• Every day.
• Monument Health is an Equal Opportunity/Affirmative Action employer.
• All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.