Patient Services Specialist

The Patient Services Specialist at Monument Health is responsible for managing pre-arrival prior authorization services, ensuring timely and accurate patient access to medical services. This includes verifying insurance eligibility, determining the need for pre-certifications, and effectively communicating with clinical staff and patients to secure necessary authorizations. Maintaining compliance with regulatory requirements while providing an excellent customer service experience is key in this role.

To apply for the Patient Services Specialist position at Monument Health, candidates are required to have a High School Diploma or GED equivalent. Preferred qualifications include at least 1 year of experience in Health Care Services, customer service, or patient scheduling, along with an associate’s degree in a healthcare-related field. These qualifications help ensure that applicants are well-prepared to support patients in navigating their healthcare journeys.

Yes, the Patient Services Specialist position at Monument Health may be eligible for remote work in states including Alaska, Florida, Georgia, Nebraska, Ohio, South Carolina, South Dakota, Tennessee, Wyoming, and Kentucky. This flexibility allows professionals to contribute effectively while maintaining a healthy work-life balance.

Monument Health offers a range of competitive benefits for the Patient Services Specialist role, including medical, vision, and dental coverage, retirement plans, health savings accounts, and more. Candidates can also take advantage of tuition assistance, a paid time off accrual bank, and instant pay options, making this position not only fulfilling but rewarding.

As a Patient Services Specialist at Monument Health, you will advocate for patients by effectively addressing challenges related to pre-authorization approvals and denials. You’ll work closely with leadership to resolve issues, ensuring compliance with financial clearance policies while guiding patients through available resources and financial assistance options.

When answering this question, detail any experiences you have in verifying insurance eligibility and benefits coverage. Highlight the methods you've used, such as utilizing EHR systems or direct communication with payers, and discuss how you ensured accuracy to facilitate care.

To answer this question, provide an example of a challenging interaction you've faced. Emphasize your approach to communication, skills in empathy, and problem-solving techniques while ensuring compliance with healthcare regulations.

Your response should show your knowledge of the differences between pre-certification and pre-authorization. Discuss your experience in managing these processes, the importance of timely approvals, and how they impact patient care.

In your response, mention specific tools like Electronic Health Records (EHR) or other add-on software you've utilized. Describe how you've leveraged these tools to enhance accuracy and efficiency in managing patient authorizations and records.

Highlight the significance of teamwork in the healthcare environment. Explain how effective collaboration with healthcare providers, clinical staff, and departments is necessary for maintaining patient care quality and ensuring all authorizations and financial clearances are handled efficiently.

Discuss strategies such as assessing urgency, utilizing a workflow system to track requests, and maintaining clear communication with team members. Stress your organization skills and ability to remain calm under pressure.

Explain your approach to addressing a denial, including reviewing the documentation, contacting the payer for further clarification, discussing options with the patient, and working on appeals if necessary. Emphasize your commitment to patient advocacy.

Mention any relevant professional development activities, such as attending workshops, subscribing to industry newsletters, or participating in webinars. Highlight your proactive approach to continuous learning in relation to healthcare regulations.

Utilize the STAR method (Situation, Task, Action, Result) to outline a specific instance where you identified a process inefficiency, implemented a change, and measured the outcome. This demonstrates your problem-solving skills and initiative.

Convey your passion for helping others, sharing any personal experiences that connect you to healthcare. Emphasize how the role of Patient Services Specialist aligns with your values and desire to create a positive impact in community health.