Patient Access Representative

JOB TITLE: Patient Access Representative


DEPARTMENT: Patient Access

REPORTS TO: Patient Access Director

FLSA STATUS: Non-Exempt

SUPERVISES STAFF: No

BLOODBORNE PATHOGENS EXPOSURE: Classification 1

JOB SUMMARY: The Patient Access Representative will be responsible for confirming demographic information, insurance verification, scheduling appointments, collecting payments and providing excellent customer service at all times. The Patient Access Representative will also be responsible for the management and efficiency of Provider schedules; working closely with clinical staff and ancillary departments within the healthcare center. The Patient Access Representative will lead the organization in building trust, comfort and rapport with patients and potential patients.


ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:

1. Schedules patient appointments and enters required information in the computer system in an accurate and timely manner.
2. Obtains demographic, insurance and financial information from patient or guarantor. Enters information in computer system efficiently.
3. Explains all required forms to the patient or guarantor and obtains the necessary signatures.
4. Ensures medical necessity compliance by obtaining necessary data and communicating information to patient or guarantor.
5. Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility.
6. Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes.
7. Posts payments in the computer system and generates the appropriate patient receipts.
8. Monitor reviews and resolves patient account issues on assigned reports.
9. Communicates in an effective and professional manner with Physicians, ancillary departments, nursing staff, physicians' office staff, insurance companies, as well as patients and their families (all Patient Access customers). Completes thorough and accurate documentation.
10. Meeting metrics and completing reports as assigned.
11. Participate in projects and meetings, and complete other tasks assigned by management.

SKILLS AND EXPERIENCE:

1. One year of work experience in a medical setting, or three years of customer service/receptionist experience preferred.
2. Must have excellent customer service skills demonstrating Strong verbal, written and communication skill along with active listening skills.
3. Comfortable working in a fast-paced environment.
4. Must have a strong work ethic and the ability to handle a variety of tasks.
5. Demonstrates initiative and works cooperatively to identify and implement quality improvements.
6. Demonstrates teamwork and respect for fellow staff, team members, patients, and community partners.
7. Exercises problem-solving and conflict resolution skills when handling patient or staff complaints.
8. Cultural sensitivity and demonstrated ability to work with diverse groups of people.
9. Highly professional, personable and must share the organizations mission to patient care.
10. Familiarity with office machines, such as computers, faxes, photocopiers.
11. Knowledge of basic math, billing and insurance principals.
12. Must be flexible to grow with the organization as well as the ability and willingness work alternative shifts and/ or weekends and travel to multiple locations as needed.
13. Practices confidentiality and privacy protocols in accordance with clinic and HIPAA regulations.

EDUCATION/LICENSURE/CERTIFICATION QUALIFICATIONS:

MINIMUM JOB REQUIREMENTS/EDUCATION

1. High school diploma or GED certificate

3. Typing ability required.

4. Bilingual in Spanish Preferred.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

PHYSICAL DEMANDS:

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle and feel objects, tools and controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch and crawl; talk and hear; taste and smell. The employee must occasionally lift and/or move up to 30 pounds. Specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK DEMANDS:

Work Environment:

Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is not exposed to weather conditions. The noise level in the work environment is usually moderate.

Hours:

Employees will be assigned to a regular work schedule, which may include hours before 8:00 am, after 5:00 pm, and Saturdays as determined by department needs and requirements.

SKILLS AND EXPERIENCE:

1. One year of work experience in a medical setting, or three years of customer service/receptionist experience preferred.
2. Must have excellent customer service skills demonstrating Strong verbal, written and communication skill along with active listening skills.
3. Comfortable working in a fast-paced environment.
4. Must have a strong work ethic and the ability to handle a variety of tasks.
5. Demonstrates initiative and works cooperatively to identify and implement quality improvements.
6. Demonstrates teamwork and respect for fellow staff, team members, patients, and community partners.
7. Exercises problem-solving and conflict resolution skills when handling patient or staff complaints.
8. Cultural sensitivity and demonstrated ability to work with diverse groups of people.
9. Highly professional, personable and must share the organizations mission to patient care.
10. Familiarity with office machines, such as computers, faxes, photocopiers.
11. Knowledge of basic math, billing and insurance principals.
12. Must be flexible to grow with the organization as well as the ability and willingness work alternative shifts and/ or weekends and travel to multiple locations as needed.
13. Practices confidentiality and privacy protocols in accordance with clinic and HIPAA regulations.

EDUCATION/LICENSURE/CERTIFICATION QUALIFICATIONS:

MINIMUM JOB REQUIREMENTS/EDUCATION

1. High school diploma or GED certificate

3. Typing ability required.

4. Bilingual in Spanish Preferred.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

PHYSICAL DEMANDS:

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle and feel objects, tools and controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch and crawl; talk and hear; taste and smell. The employee must occasionally lift and/or move up to 30 pounds. Specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK DEMANDS:

Work Environment:

Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is not exposed to weather conditions. The noise level in the work environment is usually moderate.

Hours:

Employees will be assigned to a regular work schedule, which may include hours before 8:00 am, after 5:00 pm, and Saturdays as determined by department needs and requirements.