Job Overview
Location
Indiana, USA
Job Type
Full-time
Category
Customer Success Manager
Date Posted
February 28, 2026
Full Job Description
đź“‹ Description
- • As a Pre-Service Center (PSC) Specialist at BMC Software, Inc., you will be an integral part of the Revenue Cycle Patient Access team, playing a critical role in ensuring seamless financial clearance for patients. This remote position is designed for individuals who are meticulous, proactive, and possess a strong understanding of healthcare insurance processes.
- • Your primary responsibility will be to coordinate all financial clearance activities. This encompasses a wide range of tasks, including pre-registration, acquiring or validating essential patient demographic and insurance information, and securing necessary referral authorizations or precertification numbers.
- • You will also be responsible for collecting pre-service cash payments, thereby maximizing hospital reimbursement while ensuring timely access to care for our patients.
- • This role demands a commitment to adhering to established quality assurance guidelines and meeting productivity standards to contribute effectively to the work unit’s performance expectations.
- • You will report to the Pre-Service Center Supervisor and will engage in crucial interactions and collaborations with a diverse group of stakeholders. These include, but are not limited to, insurance company representatives, patients, physicians, BMC practice staff, case management, and Patient Financial Counseling.
- • A key aspect of your role will be to monitor accounts routed to registration, referral, and prior authorization work queues. You will be tasked with clearing these queues by diligently obtaining all required patient and/or payer-specific financial clearance elements, strictly in accordance with established management guidelines.
- • Maintaining up-to-date knowledge of and strict compliance with insurance companies’ requirements for obtaining prior authorizations and referrals will be paramount. You will complete all necessary activities to facilitate every aspect of financial clearance.
- • You will serve as a subject matter expert in navigating both BMC and payer policies to secure the appropriate approvals (such as authorizations, pre-certifications, and referrals) necessary for scheduled care to proceed.
- • The PSC Verification Specialist is a vital component of the broader patient care team, assisting clinicians in understanding the payer requirements essential for providing patients with the widest possible access to services.
- • You will provide hands-on support to BMC staff at all levels, aiding them in understanding and navigating complex financial clearance issues.
- • Employing the most efficient strategies for obtaining insurance verification, authorizations, and referrals will be a core function. This will involve utilizing online databases, electronic correspondence, faxes, and phone calls.
- • You will be responsible for obtaining and clearly documenting all referral and prior authorizations for scheduled services prior to admission within the Epic environment.
- • A collaborative approach is essential as you work closely with primary care practices, specialty practices, referring physicians, primary care physicians, insurance carriers, patients, and other parties to ensure that required managed care referrals and prior authorizations for specified specialty visits and other services are obtained and appropriately recorded in the relevant practice management systems.
- • You will ensure that approval numbers are accurately linked to the relevant patient appointment or visit.
- • When a valid referral is determined to be missing, you will utilize computer-based tools or contact the appropriate party to obtain or generate the referral/authorization and related information, recording it in the practice management system.
- • You will proactively contact internal and external primary care physicians to obtain necessary referral/authorization numbers.
- • Performing follow-up activities as indicated by relevant management reports and work queues will be a regular duty.
- • Collaborating with patients, providers, and departments to resolve any issues or problems encountered in obtaining required referral/prior authorizations is crucial.
- • You will work in tandem with practices to resolve registration, insurance verification, referral, or authorization issues that impede the process of obtaining a referral/authorization.
- • Escalating accounts that have been denied or will not be financially cleared, in accordance with department policy, is a key responsibility.
- • Whenever possible, you will interview patients, families, or referring physicians via telephone in advance of the patient’s appointment or visit to gather all necessary information, including financial and demographic details required for reimbursement and compliance.
- • You will accept registration updates from various intake points, such as paper forms, internet registration forms, practice telephones, and direct calls from patients and facilities.
- • Ensuring that all updated demographic and insurance information is accurately recorded in the appropriate registration systems for primary, secondary, and tertiary insurances is vital.
- • You will review all registration and insurance information within systems and reconcile it with data available from insurance carriers. For any insurance updates, you will leverage available resources to validate the information, including plan eligibility, primary care physician, subscriber information, employer details, and appointment/visit specifics.
- • You will contact patients as necessary for clarifications or follow-up, always maintaining a sensitive, customer-friendly approach.
- • For new patients to BMC, you will create a new registration record, accurately obtaining all required data elements, generating a medical record number, and completing a full registration.
- • For self-pay patients or those with unresolved insurance, you will refer them to Patient Financial Counseling.
- • You will process copayments, coinsurance, and deductibles for scheduled visits and outstanding patient balances during the pre-registration process.
- • Maintaining the confidentiality of patients’ financial and medical records, adhering to State and Federal laws, and advising management of any potential compliance issues immediately are non-negotiable aspects of this role.
- • You will participate in educational offerings and development opportunities, complying with all organizational workflows and policies.
- • Demonstrating the ability to provide a high level of customer experience, recognizing situations requiring escalation, and establishing effective collaborative relationships with revenue cycle staff for continuous improvement are expected.
- • You will be encouraged to learn other roles and processes, assisting with process improvement initiatives as directed.
- • Consistently meeting productivity and quality expectations is essential for success in this role.
- • Handling telephone calls efficiently, following scripting and customer service standards, and appropriately managing or referring calls is a daily requirement.
- • You will regularly undergo Managed Care Quality Audits to achieve the required standard.
- • You will contact the Help Desk to report any system or hardware issues.
- • Organizing and maintaining your work area for efficiency, neatness, and safety is expected.
- • Communicating effectively and courteously with all internal and external customers is paramount.
- • Adhering to all of BMC’s RESPECT behavioral standards is mandatory.
🎯 Requirements
- • High School diploma or equivalent required. Additional professional certifications or completion of Revenue Partners training programs are preferred. SDK class training is strongly preferred.
- • At least one year of registration experience. Advanced knowledge of insurance payers and their requirements.
- • Strong understanding of healthcare insurance (HMO, PPO, authorizations), with knowledge of healthcare terminology and CPT/ICD-10 codes.
- • Experience with Epic preferred, including proficiency in Epic workqueues.
- • Advanced computer proficiency, including Microsoft Office Suite (Excel, Word, Outlook, Teams) and strong data entry/interpretation skills.
- • Excellent verbal and written English communication skills; able to work effectively in complex environments with diverse perspectives.
🏖️ Benefits
- • Medical, dental, and vision insurance.
- • Pharmacy benefits.
- • Contract increases and potential for career advancement opportunities.
- • Flexible Spending Accounts (FSAs).
- • 403(b) savings plan with employer match.
- • Earned time cash out and paid time off.
- • Resources to support employee and family well-being.
Skills & Technologies
Remote
About BMC Software, Inc.
BMC Software, Inc. develops and markets enterprise software for IT service management, automation, and optimization. Founded in 1980 and headquartered in Houston, Texas, the company provides solutions for mainframe, cloud, and DevOps environments, helping organizations manage digital operations, secure assets, and deliver services efficiently. Its portfolio includes Helix, Control-M, and MainView platforms. BMC serves Fortune 500 companies and government agencies across finance, healthcare, and telecommunications sectors, focusing on reducing IT costs, ensuring compliance, and accelerating innovation through automated workflows and data-driven insights.
