Patient Access Representative

Job Description

Job Description

Patient Access Representative

40 hours per week 

Dept: Registration

Schedule: Days 5am-1:30pm or 6am-2:30pm ( Must be able to work both shifts)

Job type: Full Time 

Role/Position Definition:  

The Patient Access Representative is responsible for accurately collecting and analyzing all required demographic, insurance, financial and clinical data elements necessary to register patients. Responsible for the provision of routine patient access activity to facilitate efficient operations, expeditious reimbursement and optimal consumer satisfaction and to promote teamwork. Responsible for furthering the mission of Surgeons Choice Medical Center while consistently demonstrating the hospital’s core values. Performs his/her duties in accordance with regulatory compliance requirements and the Hospital’s Code of Conduct. 

Qualifications/Position Requirements:

  Education/Experience:  

• High School Diploma or G.E.D. required.
• At least two years of medical clerical experience preferred.
• Office experience in a healthcare setting preferred.

  Licensure/Certification:

• BLS certification preferred.  

  Knowledge, Skills and Abilities

• Proficient reading and writing skills.
• Proficient in computer usage (i.e. Windows-based operating system, Microsoft Office).
• Proficiency in the use of general office equipment (i.e. copier, facsimile, telephones).
• Proficient knowledge of Heath Information Systems.
• Knowledge of human anatomy and physiology.
• Strong communication, time management, organization, and customer service skills

are necessary to excel in this position.

• Ability to work in a high-volume environment.
• Knowledge of managed care and third-party payer benefit designs and reimbursement requirements.
• Understanding of medical terminology, HIPAA privacy laws.
• Understanding of CPTs ( Current Procedural Terminology ).

Duties & Responsibilities: 

• Assumes any and all clerical duties and responsibilities, as necessary.
• Assists in ordering and stocking clerical supplies.
• Assists in maintaining cost effectiveness by preventing waste of supplies.
• Develops and maintains a good working rapport with interdepartmental personnel as well as other department areas within the facility.
• Verifies necessary information (i.e. procedure, patient demographics and insurance coverage) and records in the electronic medical record, (i.e. CPSI).
• Updating demographic information, as needed.
• Identifying a source of payment, obtaining sufficient information to permit reimbursement, ensuring the information is complete and accurate and interfacing with insurers and members of the healthcare team.
• Verifies insurance benefits and/or referral and obtain pre- certification/authorization for diagnostic procedures.
• Ability to assess the patient’s financial status and coverage provisions prior to scheduling procedures and routinely communicates with manager/director regarding collection concerns, questionable coverage and benefits.
• May be required to do Charge Entry/Audit/Follow-up for all procedures performed at the unit/site.
• Collect copays and payments on accounts and post payments in EMR.
• Considers patient rights in performance of job duties and responsibilities.
• Interacts appropriately with various age groups.
• Accurately interprets age-specific patient responses to questions and instructions.
• Considers age-specific patient requirements when responding to emergency situations.
• Reviews forms for patient signature; obtains forms or signature(s) as required.
• Provides information to the patient's family in the waiting area according to facility policy.
• Monitors the reception and waiting areas.
• Coordinates reception area activities for effective communication throughout the facility.
• Answers telephone courteously.
• Receives and relays messages effectively.
• Contributes to the progress and development of the approved Quality Management Program.
• Prepares statistical reports as required.
• Maintains compliance with Surgeons Choice Medical Center’s policies, procedures and accrediting bodies.
• Communicates effectively with patients, visitors, physicians, and co‑workers, with interactions being respectful and courteous.
• Keeps the office neat and orderly.
• Adheres to safety policies and procedures in performing job duties and responsibilities.
• Safety problems are identified and corrective actions taken. 
• Reports on observed or suspected violations, hazards, and noncompliance according to facility policy.
• Maintains and promotes professional competence through continuing education and other learning experiences.
• Seeks new learning experiences by accepting challenging opportunities and responsibilities.
• Objectively evaluates suggestions or criticisms and attempts to improve performance or seeks further guidance, as needed.
• Attends and actively participates in meetings, committees, in-services, workshops, seminars, and conferences according to job responsibilities and facility requirements.
• May be required to conduct tours of the facility.
• Performs all other duties as assigned.

Perks for our staff: 

• Competitive hourly pay !
• NO WEEKENDS, HOLIDAYS OR ON-CALL! 
• Health Safety Measures in place for everyone
• A diverse & inclusive workforce that embraces communication, caring and courtesy.
• Positive Onboarding Experience
• Generous PTO accrual at start of employment.
• Tuition Reimbursement & Continuing Education opportunities
• 401k with company match
• Company Events
• Community Discounts
• And more!