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Job Description
Patient Services Specialist IV
Lubbock
44851BR
Position Description
The PSS IV works autonomously to lead quality assurance reviews, provides feedback to peers, and collaborates with supervisors on process improvement initiatives that impact clinic patient flow. Serves as a point of contact for escalated registration, billing, insurance authorizations, and/or patient concerns. Can train other PSS team members.
Major/Essential Functions
Referral Coordination & Authorization Management- Coordinate and process incoming and outgoing patient referrals in a timely and accurate manner.
- Review referral orders for completeness, required clinical documentation, medical necessity, and payer-specific requirements.
- Obtain and manage insurance authorizations for specialty services, procedures, and diagnostic testing.
- Monitor referral and authorization work queues to ensure appropriate follow-up, status updates, and closure of referrals.
- Resolve complex or escalated referral, scheduling, insurance, and authorization issues with minimal supervision.
- Maintain accurate documentation within the electronic medical record (EMR) and scheduling systems.
- Serve as a liaison between referring providers, specialty clinics, ancillary departments, and external healthcare offices.
- Communicate referral status updates, scheduling barriers, authorization delays, and documentation needs to providers and clinical teams.
- Collaborate with clinic leadership and care teams to support continuity of care and efficient patient flow.
- Ensure providers receive necessary referral documentation before specialty appointments or procedures.
- Communicate with patients regarding referral status, insurance authorization requirements, scheduling updates, and next steps in care.
- Assist patients with scheduling referred appointments and provide instructions related to specialty visits or required documentation.
- Address escalated patient concerns professionally and effectively while maintaining patient confidentiality and service excellence.
- Promote a positive patient experience through timely communication and problem resolution.
- Perform quality assurance reviews of referral and authorization workflows to ensure compliance, accuracy, and operational efficiency.
- Identify workflow gaps, referral delays, and process improvement opportunities impacting clinic operations and patient access.
- Collaborate with supervisors and leadership to implement process improvements that enhance referral turnaround times and clinic efficiency.
- Support compliance with departmental policies, payer guidelines, HIPAA regulations, and organizational standards.
- Serve as a resource and mentor for referral coordinators, Patient Service Specialists (PSS), and clinic support staff.
- Assist with onboarding, cross-training, and education related to referral workflows, insurance authorization processes, and work queue management.
- Provide feedback and guidance to peers to promote consistency, accountability, and high-quality service standards.
Required Qualifications
High School diploma or equivalent, and five (5) years of related experience.
To apply, please visit: https://sjobs.brassring.com/TGnewUI/Search/home/HomeWithPreLoad?partnerid=25898&siteid=5283&PageType=JobDetails&jobid=914275
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information or status as a protected veteran.
The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act is a federal statute requiring colleges and universities participating in federal financial aid programs to maintain and disclose campus crime statistics and security information. By October 1 of each year, institutions must publish and distribute their Annual Campus Security Policy & Crime Statistics Report (ASR) to current and prospective students and employees. You can locate this report through our website at: https://www.ttuhsc.edu/emergency/clery-report.aspx.
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ABOUT THE COMPANY
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Texas Tech University Health Sciences Center
Show moreAbout Us
Nationally recognized for innovative programs, academic achievement, cutting-edge research and exceptional patient care, Texas Tech University Health Sciences Center aims to promote a greater health environment for West Texas and beyond. While our flagship campus resides proudly in Lubbock, Texas, TTUHSC operates five schools with campuses in Abilene, Amarillo, Dallas/Fort Worth, Lubbock and the Permian Basin (Midland & Odessa).
Like Texas itself, we are an independent and proud institution that is part of a larger union, the Texas Tech University System. As a university separate from Texas Tech University, we have been entrusted with a singular charge: to teach the next generation of doctors, nurses, pharmacists, researchers and health care professionals while simultaneously providing the people of West Texas with world-class patient care. We are both an institution of higher learning and a place where real people come for life-saving medical care.
Our Mission
As a comprehensive health sciences center, our mission is to enrich the lives of others by educating students to become collaborative health care professionals, providing excellent patient care, and advancing knowledge through innovative research.
Our Values & Culture
Through our values-based culture, TTUHSC is committed to cultivating an exceptional workplace community with a positive culture that puts people first. Our five values guide our actions and principles: Beyond Service, Kindhearted, Integrity, One Team, and Visionary.
Compensation & Benefits
We are proud to offer many exceptional employee benefits, including a generous compensation package with comprehensive benefits, medical and dental insurance, paid time off and substantial automatic retirement contributions. Additionally, we invest in employee success by providing many resources designed to support your personal and professional growth, including:
- Comprehensive Health Plans and Other Core Insurance
- State Retirement Programs and Pension Options
- Retiree Insurance for Lifetime Medical Benefits
- Continuing Education & Lifelong Learning Programs
- Tuition scholarships for employees and their dependents
- Leadership and Professional Development Programs
- Mental and Physical Wellness Programs
- Employee Recognition Programs and Longevity Pay
We are excited for you to consider joining our team at the Texas Tech University Health Sciences Center. Consistently ranked as a "Great College to Work For" by the Chronicle of Higher Education, TTUHSC provides so much more than just a job!
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