Patient Access Representative

Patient Access Representative

Patient access responsibilities include a wide range of duties aimed at facilitating patient access to healthcare services. These responsibilities generally involve patient registration, appointment scheduling, insurance verification, and providing information and support to patients. Patient access representatives, in particular, are often the first point of contact for patients, greeting them, collecting necessary information, and guiding them through the initial stages of their healthcare experience.

Essential Duties and Responsibilities

• Creating a welcoming and efficient environment for patients, addressing their needs, and providing support throughout the initial stages of their healthcare journey.
• Collect accurate demographic information (e.g., name, address, phone number, date of birth, insurance information) and enter it into the system. Update existing patient records with any changes. Obtains applicable consents and any required form(s) from patient.
• Verify patients' insurance coverage by contacting insurance providers or EHR Real Time Eligibility, or using online verification systems and ensuring the correct coverage is on the patients account.
• Ensure necessary pre-authorizations or referrals for services are obtained. Explain insurance benefits and financial responsibilities to patients.
• Provide exceptional customer service by answering phones promptly and professionally, addressing concerns, and providing information.
• Adhere to all HIPAA regulations and maintain patient confidentiality.
• Collect co-pays, deductibles, co-insurance, and balance payments in accordance with hospital policy.
• Assures hospital compliance with all regulatory agency requirements.
• Produces and distributes patient estimates.
• Maintains work queues to ensure efficient claims processing, patient satisfaction, and organizational financial health.
• Assists patients with navigating and using the online patient portal.
• Be flexible and adaptive as work assignment and area may shift based on business needs and priorities.

Education

• High school diploma or GED required. Certificate or diploma from a school specializing in Medical Front Office and/or Medical Terminology preferred.

Work Experience

• Six months of office and/or call center, customer service or healthcare experience is preferred.
• Knowledge of computers and other standard office equipment required.

Certification/License

• N/A

Mental/Physical Requirements

• Ability to concentrate, pay close attention to detail and perform duties under time restrictions. Normal mental concentration on variable operations for short periods of time and moderate concentration with repetitive operations for long periods of time. Work involves extensive use of computer with frequent interruptions. Ability to stand, walk, sit and reach. Must be able to assist and transport patients in wheel chairs. Ability to lift 10lbs required.

Working Conditions

• The standard office conditions with more than average noise. Periodic contact with conditions such as fumes, noise, chemicals, hazards, and/or diseases. Ability to work shifts is required.