Admin Patient Representative

Job Summary: We are seeking a detail-oriented, patient-focused, and bilingual (English/Spanish) Administrative Patient Representative to support our clinical team. This position plays a key role in facilitating patient communications and assisting with clinical administrative workflows to ensure timely patient care and exceptional service. Primary responsibilities include managing prior authorizations, processing medication refill requests, responding to patient messages, and supporting providers with various clinical administrative tasks. The ideal candidate is organized, compassionate, and able to effectively communicate with a diverse patient population in both English and Spanish.

Key Responsibilities:

• Prior Authorizations: Coordinate and complete medication and procedure prior authorization requests with insurance carriers to facilitate patient access to care.
• Medication Refill Requests: Process and follow up on prescription refill requests in collaboration with providers and clinical staff.
• Patient Communication: Respond to patient inquiries and messages through patient communication platforms such as Klara, ensuring timely, professional, and compassionate service.
• Clinical Administrative Support: Assist providers and clinical staff with administrative tasks related to patient care, treatment plans, referrals, and follow-up needs.
• Message Management: Monitor and manage patient communication queues, ensuring all requests are addressed appropriately and within established timeframes.
• Documentation: Maintain accurate and complete documentation of patient interactions, refill requests, prior authorizations, and other administrative actions within the electronic medical record.
• Patient Support: Communicate effectively with English- and Spanish-speaking patients regarding medication requests, appointment-related needs, and other administrative matters.
• Compliance: Adhere to HIPAA regulations and organizational policies regarding patient confidentiality and data security.

Skills & Qualifications

• Bilingual Communication Skills: Fluent in both English and Spanish, with the ability to communicate professionally and effectively with patients, providers, and staff both verbally and in writing.
• Experience: Previous experience in a healthcare administrative, medical office, patient services, or ophthalmology setting preferred.
• Software Proficiency: Experience with EHR/EMR systems and patient communication platforms such as ModMed, EMA, Klara, or similar applications preferred.
• Attention to Detail & Accuracy: Demonstrates precision in completing tasks while maintaining accurate documentation and minimizing errors.
• Confidentiality & Compliance: Maintains patient confidentiality and complies with HIPAA regulations and all applicable privacy and security standards.
• Organizational & Time Management Skills: Effectively prioritizes tasks, manages multiple responsibilities, and meets deadlines in a fast-paced healthcare environment.
• Problem-Solving Skills: Applies sound judgment and critical thinking to resolve issues efficiently and escalate concerns when appropriate.
• Communication Skills: Strong interpersonal skills with the ability to build trust and rapport with patients and team members through clear, compassionate communication.
• Teamwork & Adaptability: Works collaboratively with providers and staff while adapting to changing priorities and patient needs.

Benefits:

• Health insurance
• Dental Insurance
• Life Insurance
• Accidental Death & Dismemberment Insurance
• 401(K)
• PTO and holidays off
• Career growth and development