Patient Representative

California Kidney Specialists (CKS) is seeking an experienced Patient Representative to join our U.S.-based nephrology practice. This role is based in Karachi, Pakistan, and requires on-site work during the night shift from 9:00 PM to 5:00 AM. The ideal candidate will have a strong background in patient access and healthcare administration, with a focus on supporting patients and coordinating with various stakeholders to ensure smooth scheduling and insurance processes.

Key Responsibilities

- Schedule new-patient and follow-up appointments efficiently.
- Register patients and verify their demographic and insurance information.
- Check insurance eligibility and benefits using payer portals.
- Identify referral and prior-authorization requirements and submit authorization requests.
- Follow up on authorization requests to ensure timely approvals.
- Coordinate communication between patients, referring offices, insurance companies, healthcare providers, and clinic staff.
- Request missing referrals, medical records, insurance documents, and authorization information as needed.
- Confirm appointments and clearly explain administrative requirements to patients.
- Maintain accurate notes and update patient information using Cerner.
- Escalate issues related to authorization delays, denials, incomplete referrals, and scheduling conflicts.
- Protect patient information by adhering to HIPAA and organizational privacy policies.

Required Qualifications

- Previous experience in patient access, medical scheduling, healthcare call centers, or similar healthcare roles.
- Hands-on experience with Cerner or Oracle Health systems.
- Solid knowledge of U.S. health insurance processes, including eligibility, benefits, referrals, and prior authorizations.
- Experience using insurance payer portals for verification and authorization.
- Strong spoken and written English communication skills.
- Professional telephone etiquette and patient service skills.
- Exceptional attention to detail, organizational abilities, and follow-up skills.
- Ability to work on-site in Karachi during the specified night shift hours.

Preferred Qualifications

- Experience supporting a U.S. medical practice.
- Background in nephrology or other specialty-care practices.
- Familiarity with Medicare and commercial insurance plans.

This position offers the opportunity to work with a dedicated team supporting patients with kidney-related health needs while gaining valuable experience in U.S. healthcare administration. If you meet the qualifications and are comfortable with the night shift schedule, this role could be an excellent fit for your skills and career goals.