Patient Access Rep Clinic

Patient Access Rep Clinic

Franciscan Medical Group, Bainbridge Island, Washington

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.

The posted compensation range of $23.90 - $32.07/hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Job Summary and Responsibilities

As a Patient Access Representative, you will manage administrative duties for the patient intake process in our clinic, adhering to established guidelines. Every day you will interact with patients in person and by phone, facilitating check-in/out, collecting data and payments, validating insurance, scheduling appointments, and processing referrals and authorizations. To be successful, you will demonstrate critical thinking, strong customer service, and knowledge of insurance, billing, and medical terminology, ensuring a seamless, high-quality patient intake experience.

• Registers and/or checks patients in/out.
• Performs patient check-in at the time of visit; records and verifies all demographic, insurance and other information (e.g. Workers' Comp, other third-party liability info); follows established procedures to ensure that all registration guidelines/requirements have been satisfied, including ensuring minors' guardians have been notified; identifies deficiencies and resolves non-complex issues or escalates to appropriate staff for further action. Conducts routine insurance eligibility verifications. Copies/scans patient access related hardcopy materials (e.g. ID, referrals, L&I, insurance cards, etc.) into correct location in electronic medical record. Records non-clinical charges from various sources. This could include entering charges for the completion of forms, for Depositions/Attorney Fees, for retail fees, etc. Handles and reconciles payments. Collects appropriate co-payments, co-insurances, and other fees/monies due, including cash payments (in accordance with FMG Business Office Cash Handling Procedures); posts payments to patient accounts.
• Collects payments at the time of check-in or check-out where appropriate. Performs end-of-day payment reconciliation; balances and closes out cash drawers; ensures that outstanding tasks are completed and that preparation work for the next day's clinic is completed or assigned to other staff. Continually monitors and reconciles issues prior to patient visit. Researches to identify and reconcile remaining issues before patients arrives for their appointment. Makes registration and other front-end corrections. Ensures that all missing/erroneous/incomplete information is updated. Ensures that all insurance eligibility checks are conducted where possible. Resolves edits in the work queues. Processes referral orders and/or pre-authorizations.
• Ensures that insurance eligibility checks have been conducted on all referrals before the patient is seen, either by escalating to the Insurance Verifier, or by directly checking on eligibility. Completes referrals and/or pre-authorization, before the patient is seen, for diagnostic testing, therapy, surgeries, procedures and specialty care according to requirements and patient preference. Provides information to patients regarding their health care plan; interprets and communicates plan policies and procedures to employees, physicians and members (patients). Provides patients with answers to billing and insurance clarification questions; obtains a cost estimate when requested, and explains insurance benefit coverage to patient. Notifies physician(s) and patient when referral is denied or if a second opinion or additional info is needed. Updates the patient's medical record as necessary. Copies/scans documents into correct location within electronic medical record.
• May interact with referring clinic to ensure successful coordination of patient care. Coordinates appointments and ancillary services. Schedules patients for multiple providers and clinics if assigned to Call Center work unit. Coordinates patient clinic visits based on authorized referral in accordance with established standards and procedures; gathers and documents insurance eligibility data, conducting routine verifications that can be done quickly during conversation; enters data in patient's electronic medical record as appropriate. Identifies patients requiring contact to confirm a referral appointment; contacts patient in accordance with established procedures. Contacts and follows up with patients to reschedule a missed/cancelled appointment; documents reason(s) for no-show in accordance with established procedures; notifies management if patient has violated a policy and further action is required.
• Makes arrangements for addressing special/ancillary patient requirements, including transportation, interpreters and other needs relating to patient care and satisfaction.

Job Requirements

Required

• One year of customer service work experience and
• None, upon hire

Preferred

• Two years of customer service work experience and
• Healthcare or Call Center experience

Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area. Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person body, mind, and spirit in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth. Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care. We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose.

Total Rewards

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards.

CommonSpirit Health is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].

CommonSpirit Health will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at View phone number on click.appcast.io and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health participates in E-Verify.