At Pioneer Counseling and Consulting and Behavioral Health, "The Patient Care Specialist" (PCS) serves as the first point of contact for patients and a central coordinator among clinical staff, insurance carriers, billing partners, and intake processes at Pioneer Counseling and Consulting. This role helps ensure that each patient’s experience—from initial inquiry through ongoing care—is handled with warmth, accuracy, responsiveness, and professionalism.
This position requires a compassionate, detail-oriented professional who can support insurance verification, benefits coordination, patient intake, scheduling communication, and internal team follow-up. The PCS navigates behavioral health insurance processes with accuracy and care while advocating for patients through clear communication and thoughtful support.
PRIMARY RESPONSIBILITIES
The following responsibilities represent the essential functions of the Patient Care Specialist.
A. Insurance Verification & Coordination of Benefits (COB)
● Verify insurance eligibility and benefits for new and existing patients before scheduled appointments. When volume requires support, delegate appropriate tasks to team members and collaborate with the clinical supervisor and administrative team to ensure timely completion.
● Conduct Coordination of Benefits (COB) reviews to determine primary and secondary insurance coverage for all new patients and for patients with new, changed, or terminated insurance coverage.
● Confirm in-network and out-of-network status for Pioneer Counseling and Consulting providers during insurance verification.
● Contact insurance carriers directly to resolve discrepancies or obtain required authorizations.
● Maintain accurate, current insurance records in the practice management system.
● Communicate verified benefits clearly to patients, including estimated copays, deductibles, and out-of-pocket costs, and update the tracking sheet accordingly.
● Track all new and existing insurance needs for current intakes requiring COB review.
● Document EOB findings and communicate actionable items to the billing coordinator or clinical supervisor.
B. Intake Management
● Manage the full patient intake process, including documentation, records review, and insurance verification.
● Collect and review all required intake forms, consents, and demographic information.
● Ensure all documentation is complete, accurate, and compliant with HIPAA requirements.
● When scheduling, assign patients to appropriate clinicians based on availability, specialty, and insurance match, and communicate any credentialing concerns to the administrative team.
● Follow up with prospective patients who have not completed the intake process.
● Maintain the intake tracking log and report weekly intake metrics to the administrative team.
C. Billing Communication
● Communicate with patients who need to update insurance cards due to annual renewal, job changes, terminated coverage, or eligibility concerns.
● Notify the billing team promptly when a patient’s insurance has terminated or changed.
● Work directly with patients to gather updated insurance information when coverage changes.
● Serve as the communication bridge between patients and the billing team, without functioning as the billing processor.
● Alert the billing team of any known coverage gaps, lapses, or plan transitions before appointments.
● Assist patients in understanding next steps when their insurance situation changes.
● Document and relay relevant insurance status changes to appropriate team members in a timely manner.
● Work with patients to establish payment plans as needed and communicate arrangements closely with the billing team.
Required Qualifications
● High school diploma or GED required; associate’s or bachelor’s degree in healthcare administration, business, or a related field preferred.
● Minimum of 2 years of experience in a medical or behavioral health administrative role.
● Demonstrated experience with insurance verification and benefits interpretation.
● Working knowledge of HIPAA regulations and patient privacy requirements.
● Proficiency with Electronic Health Record (EHR) systems and Microsoft Office Suite.
● Strong written and verbal communication skills, with the ability to convey complex information clearly.
● Ability to manage multiple priorities simultaneously in a fast-paced clinical environment.
● Experience working with EHR systems such as Tebra/Kareo and Google Docs
Primary Location: 400 Locust Ave Washington
***Will have to be at our Mcmurray office Location from time to time.
Urgency in Hiring. Please only individuals who are interested in job placement within 2 weeks.
Pay: From $20.68 per hour
Benefits:
- Flexible schedule
- Mileage reimbursement
- Paid time off
Application Question(s):
- Experience in Patient Intake Process
Work Location: In person
