Patient Care Representative

Job Title:

Patient Care Representative

Department:
Patient Services

Reports To:

Clinic Director

FLSA Status:
Non-exempt (hourly)

Work Schedule:

Monday-Friday, 8:00 A.M.

- 5:00 P.M.

The Patient Care Representative is a vital role within Orthopaedics East & Sports Medicine Center. The Patient Care Representative will be responsible for coordinating patient surgeries, supporting the teams that schedule MRIs, injections, and physical therapy appointments, managing messages and correspondence from patients, offering financial counseling, supporting the referral process, and serving as the authorization representative for insurance companies. The role works closely with healthcare professionals to ensure high‑quality care and attention for all patients.

This position requires compliance with Ortho East’s compliance standards, including its Code of Conduct, Compliance Program, and policies and procedures. Such compliance will be an element required as part of the job duties and considered during performance evaluations.

• Coordinating patient surgeries, ensuring that patients are scheduled for the appropriate procedures and that all necessary paperwork is completed.
• Maintain and review a list of surgeries for provider(s) for potential contact and follow‑up within the post‑op period.
• Serving as the authorization representative in conjunction with our support team, ensuring that patients receive the necessary coverage for their procedures.
• Obtain authorizations and schedule referrals, diagnostic testing, physical therapy, surgical procedures, etc., as needed.
• Offering financial counseling to patients, providing information about payment options and financial assistance programs.
• Managing messages and correspondence from patients, responding to inquiries and forwarding messages to the appropriate healthcare professionals.
• Counsel patients and family members regarding physical care measures to promote improvement/recovery, symptom/complication management, expected outcomes/progression, and social employment issues and education so they can make informed decisions about their care.
• Additional duties as assigned.

• Associate degree in healthcare administration, or related field preferred.
• Minimum of 2 years of experience in a healthcare setting.
• Minimum of 2 years of patient support experience.
• Knowledge of medical terminology and procedures.
• Knowledge of insurance authorization and billing.
• Strong computer skills, including proficiency with Microsoft Office and electronic medical records systems.

• Ability to prioritize tasks and work independently.
• Experience in maintaining confidentiality in dealing with sensitive issues.
• Proven ability in making sound and accurate judgments in problem solving work issues.
• Ability to deal with frequent change, delays, and/or unexpected events.
• Successful record of follow through on commitments and demonstrated dependability.
• Must be willing to work in a team environment and contribute to building a positive team spirit.
• Must be highly organized to successfully manage multiple tasks simultaneously.
• Must demonstrate professionalism in all interactions with patients and vendors, as well as working across departmental lines to achieve goals.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The ability to stand/walk for long periods of time while performing patient duties and conversing with physicians as well as long periods of sitting and performing clerical duties, including telephone calls and keyboarding. Mobility also required to support patients throughout the building.