Patient Engagement Specialist

Patient Engagement Specialist

Job Description:

As a Patient Engagement Specialist, you will play a key role in providing exceptional patient experiences by efficiently managing patient registration, insurance verification, and pre-authorization processes. This position requires excellent attention to detail, strong communication skills, and the ability to collaborate effectively with both patients and internal departments. You will ensure a smooth registration process while maximizing patient satisfaction. Strong analytical and problem-solving skills are required to ensure a clear and accurate understanding of information.

Duties and Responsibilities:

Patient Registration

• Accurately collect and enter patient information into the system.
• Verify patient demographics, insurance coverage, and eligibility.
• Ensure compliance with registration policies and procedures.
• Provide excellent customer service to patients during the registration process.
• Collaborate with other departments to resolve registration-related issues.

Eligibility Verification

• Verify insurance coverage and benefits for patients.
• Ensure accurate and complete eligibility verification.
• Identify pre-authorization requirements and assist in obtaining them.
• Communicate insurance-related information to patients and internal teams.
• Work closely with insurance companies to resolve eligibility issues or discrepancies.

Pre-Authorization Management

• Review medical documentation and treatment plans to determine pre-authorization requirements.
• Submit pre-authorization requests to insurance companies.
• Follow up on pending or denied pre-authorizations and work to resolve them.
• Maintain accurate records of pre-authorization status and documentation.
• Collaborate with healthcare providers and insurance companies to ensure timely approvals.

Patient Communication and Support

• Serve as a point of contact for patients regarding registration, insurance, and pre-authorization inquiries.
• Provide clear and concise explanations of processes, requirements, and next steps to patients.
• Address patient concerns, questions, and complaints promptly and professionally.
• Collaborate with other departments to ensure coordinated and efficient patient care.

Process Improvement

• Identify opportunities to streamline and enhance patient engagement processes.
• Propose and implement improvements to optimize registration, insurance verification, and pre-authorization workflows.
• Collaborate with cross-functional teams to enhance the overall patient experience.

Qualifications:

• 1–3 years of experience in patient registration, healthcare operations, or medical administrative support.
• Knowledge of insurance verification, eligibility checks, and pre-authorization processes.
• Strong attention to detail and commitment to data accuracy.
• Excellent written and verbal communication skills with a patient-focused mindset.
• Ability to handle multiple tasks in a fast-paced, deadline-driven environment.
• Proficiency with electronic health record (EHR) systems, patient management software, and Microsoft Office or Google Workspace.
• Strong problem-solving skills and ability to identify process improvements.
• Ability to collaborate effectively with cross-functional teams, including clinical, administrative, and insurance departments.
• Professional demeanor with excellent customer service skills.
• Familiarity with HIPAA regulations and handling confidential patient information is a plus.

Benefits

• Great Place to Work–Certified company
• Premium HMO coverage
• Holistic employee experience programs
• Rewards and performance incentives
• Monthly engagement activities
• Career advancement opportunities
• Paid referral program