Patient Service Specialist

About

We are committed to providing high-quality pediatric care in a supportive and collaborative environment.

Position Overview

The Patient Support Specialist (PSS) plays a vital role in supporting efficient patient care through the management of medical records, referrals, prior authorizations, and provider panel maintenance. This position serves as a key liaison between patients, providers, healthcare organizations, and payers to ensure accurate documentation, seamless care coordination, and timely access to services. The PSS contributes to operational excellence, regulatory compliance, and quality improvement initiatives by maintaining accurate patient information and facilitating continuity of care.

Key Responsibilities

• Initiate, process, and track referrals to specialists, diagnostic services, ancillary providers, and community resources, ensuring timely completion and continuity of care.

• Monitor referral and records workflows, proactively identifying and resolving barriers that may impact patient access to care or operational efficiency.

• Manage incoming and outgoing medical records, including the retrieval, review, indexing, routing, and release of patient information in compliance with organizational policies, HIPAA requirements, and applicable regulations.

• Manage incoming fax queues and ensure documentation is accurately assigned and incorporated into the patient record.

• Coordinate prior authorization requests and related documentation as required by payers and referral destinations.

• Assist with well visit scheduling and management of the intake process for new patients

• Serve as a primary liaison between patients, providers, specialists, hospitals, payers, and other healthcare organizations regarding referrals, records requests, and care coordination activities.

• Maintain accurate provider panels by managing patient attribution, provider assignments, payer attribution reconciliations, and updates related to inactive patients.

• Support quality improvement and population health initiatives through accurate data management, record retrieval, referral tracking, and provider panel maintenance.

• Collaborate with providers, care coordinators, clinical staff, and administrative teams to support efficient operations and seamless patient care.

• Maintain patient confidentiality and comply with all organizational policies, HIPAA requirements, and regulatory standards.

• Participate in training, staff meetings, and ongoing professional development activities.

• Perform other duties as assigned.

Qualifications

High school diploma or equivalent.

Why Join Us?

South Carolina Pediatric Alliance offers a dynamic and supportive work environment where you can make a significant impact on the lives of our patients and their families. We provide competitive compensation, comprehensive benefits, and opportunities for professional development and growth.

Equal Opportunity Employer

South Carolina Pediatric Alliance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based on race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status, or any other basis covered by appropriate law.

Join us in our mission to provide exceptional pediatric care.

Why Join Us?

Equal Opportunity Employer

Join us in our mission to provide exceptional pediatric care.

Online Job Application

Complete the online application below.

Patient Service Specialist