Patient Access Representative

Patient Access Representative

Harbor Health Services is an innovative, growing, mission-based organization that lives, serves and collaborates with our community members to achieve our mission to help individuals reach their full potential through access to local, affordable services that promote health. Harbor provides medical, behavioral health, dental, and support services to more than 34,000 patients in Boston, the South Shore, and Cape Cod. To help further the mission of Harbor, we are looking for a talented Patient Access Representative to join our Operations team at the Harbor Community Health Center- Plymouth.

We offer an excellent, comprehensive benefits package including Health, Dental, Vision, Life, & Disability insurance, 403b Savings Plan, Generous Paid Time Off plus 11 additional Holidays and much more! Come join our great support team at the health center!

Under the direction of the Practice Manager or Central Support Manager, the Patient Access Representative provides exceptional customer service while welcoming and assisting patients, families and guests entering the Health Center. The Patient Access Representative verifies insurance eligibility and benefits prior to service, ensures accurate demographic and insurance data entry, collects co-pays, educates patients on payment options, and supports front desk operations such as appointment scheduling, check-in and check-out. This position is essential to maintaining a smooth front-end process, minimizing billing issues, and delivering an exceptional patient experience.

Responsibilities:

• Welcomes and assists patients, families, and guests in a professional and friendly manner.
• Accurately collects and enters demographic and insurance information.
• Schedules, reschedules, or cancels appointments by provider or patient request.
• Collects co-pays and process patient payments in accordance with policy.
• Ensures completeness of PCP assignment and referral requirements.
• Submits applications for HSN Presumptive Determination and SFS discounts, as needed.
• Registers walk-in and new patients and distributes new patient registration information.
• Refers patients to Financial Counselors for insurance enrollment or changes.

Insurance Verification & Financial Navigation

• Verifies insurance eligibility, coverage, and PCP/plan assignment using online portals or direct payer calls.
• Ensures prior authorizations are obtained as required in accordance with the site workflow.
• Reviews and corrects patient's demographic and insurance information in EPIC to support timely, accurate billing.
• Contacts patients in advance of appointments when insurance cannot be verified.
• Educates patients on payment options including Health Safety Net (HSN), Sliding Fee Scale (SFS), and self-pay.
• Coordinates with Financial Counselors to ensure patients have appropriate documentation and appointments. Calculates and communicates patient financial responsibility prior to service.

Administrative and Operational Support

• Reviews next-day appointment schedules and monitors appointment flow.
• Answers and routes telephone calls promptly and courteously.
• Performs related clerical tasks such as sorting mail, managing the bump list, and general front-desk support.
• Reviews patient encounters post-visit to ensure adherence to protocols and workflows to ensure all patients were properly processed, insurance and PCP assignments are accurate, follow up appointments are scheduled or documented, etc.
• Maintains strict confidentiality and a high level of professionalism in all interactions.
• Position may require occasional travel and support to other health center sites.

Requirements:

• High school diploma or GED
• 1 or more years of experience in a community health center and/or a professional or business environment, 3 or more years of healthcare related experience preferred
• Excellent verbal and written communications skills,
• Excellent customer service skills
• Excellent organizational, problem solving and priority setting skills
• Basic computer literacy, knowledge of Microsoft Office 365 preferred including Word, Excel, Outlook and Teams
• Knowledge of Electronic Practice Management (EPM) and/or Electronic Medical Record (EMR) preferred, EPIC/OCHIN desired
• Basic Math and reading comprehension skills
• Bilingual: English/Portuguese or English/Spanish preferred.
• Familiarity with using medical terminology preferred, Medical and/or Dental Billing experience preferred

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

The salary range and/or hourly rate listed is a good faith determination of base compensation that may be offered to a successful applicant for this position at the time of this job advertisement. When determining actual base salary and/or rate, several factors may be considered as applicable (e.g. location, years of relevant experience, education, training, and other factors as permissible by law). As such, most offers will not be at the top of the salary range. Shifts will include 1 evening rotation and some Saturday rotation. 40 hours weekly