Patient Services Specialist

Company: Collabera
Location: Irving
Posted on: April 13, 2025

Job Description:

About the Role:

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The role of a Utilization Management Support Specialist is to assist the clinical teams with non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care.

Responsibilities:

Perform member or provider-related administrative support tasks such as benefit verification, authorization creation and management, claims inquiries, and case documentation.


Review authorization requests for initial determination and/or triage for clinical review and resolution.


Provide general support and coordination services for the department, including answering and responding to telephone calls, taking messages, letters and correspondence, researching information, and assisting in problem-solving.


Assist with reporting, data tracking, gathering, organization, and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.



Education Qualification:

High School Diploma required



Required Skills:

3 years of experience in healthcare claims/service areas or office support


2 years of experience in a healthcare/managed care setting or prior work experience within the division


Knowledge of CPT and ICD-10 coding


Ability to effectively participate in a multi-disciplinary team


Excellent communication, organizational, and customer service skills


Knowledge of basic medical terminology and concepts used in managed care


Knowledge of standardized processes and procedures for evaluating medical support operations business practices


Excellent independent judgment and decision-making skills, consistently demonstrating tact and diplomacy


Ability to pay attention to the minute details of a project or task


Must work effectively in a fast-paced environment with changing priorities and deadlines


Must be able to meet established deadlines and handle multiple customer service demands


Must provide positive customer service to internal and external customers, including challenging customers



Pay Range:
$17.00 - $20.00 per hour

Keywords: Collabera, Plano , Patient Services Specialist, Other , Irving, Texas