Patient Access Representative

Patient Access Lead

Revenue Cycle Management is looking for a full-time Patient Access Lead to join our team! Hybrid opportunities after 90 days of in office training

SUMMARY: The Patient Access Lead is responsible for patient registration, insurance verification, and customer service functions within the patient access team. Reporting to the Patient Access Supervisor, this role supports the day-to-day operations of the team, ensuring an exceptional patient experience through accurate information collection, timely insurance verification, and professional communication. The Lead acts as a liaison between patients, staff, and departments to facilitate smooth workflow and financial clearance.

ESSENTIAL FUNCTIONS:

• Customer service: Serve as the first point of contact for patient billing inquiries. Handle high volumes of inbound and outbound calls with professionalism. Route calls appropriately and ensure messages are delivered to the correct departments. Ensure timely response to emails and medical record requests. Use EMR systems to input data and generate reports; scan and attach relevant documents. Uphold high standards of customer service in all interactions.
• Insurance Verification: Assist front office staff with complex insurance-related inquiries. Verify insurance benefits and eligibility using portals, phone calls, and other methods. Ensure authorizations are obtained and documented before surgery dates. Accurately enter insurance coverage, including co-pays and deductibles, into the EMR. Identify coverage types (e.g., PPO, HMO, workers comp) and process accordingly. Communicate effectively with physicians, billing, and other internal departments to ensure timely claim submission and resolution.
• Patient Collections Support: Handle patient inquiries related to billing and insurance claims. Contact patients with outstanding balances and offer financial assistance or payment plans. Process payments, refunds, and reconcile account discrepancies. Support account recovery efforts by collaborating with the billing and coding teams.
• Leadership: Act as resource; gives advice and instructions to employees; coaches staff on assigned tasks; facilitates problem/issue resolution. Monitor and ensure the completion of daily assignments. Identify training needs and provide timely feedback to the Patient Access Supervisor. Perform other related tasks as needed.

KNOWLEDGE, SKILLS, AND ABILITIES: Knowledge of the content, intent, and application of HIPAA, federal and state regulations Knowledge with in and out of network insurances, insurance verification, patient responsibility, and process for prior authorization Strong knowledge of medical terminology, insurance processes, and revenue cycle management Task-oriented and organizational skills; ability to complete tasks timely Detail-oriented focus; being careful about detail and thorough in completing work tasks Ability to work independently and as a team Ability to adapt with flexibility Effective communication (written/verbal), problem solving and interpersonal skills

EDUCATION AND EXPERIENCE: High school diploma or GED Two (2) years of patient access or registration experience in a medical office or facility setting

BENEFITS: 3 Medical Plans 2 Dental Plans 2 Vision Plans Employee Assistant Program Short- and Long-Term Disability Insurance Accidental Death & Dismemberment Plan 401(k) with a 2-year vesting PTO + Holidays