Patient Access Rep. I - Insurance Verification Rep. - TMCOne - Vail Cardiology

Patient Access Rep. I - Insurance Verification Rep. - TMCOne - Vail Cardiology Job Category Clerical Schedule Full time Shift 1 - Day Shift

SUMMARY :

The Patient Access Representative I – Insurance Verification is responsible for verifying insurance eligibility, securing authorizations, and ensuring accurate patient registration to support timely and complete reimbursement. This role serves as a key liaison between patients, providers, and payors, ensuring a seamless financial clearance process prior to service delivery.

ESSENTIAL FUNCTIONS:

· Verify insurance eligibility and benefits using electronic tools and payer portals.

· Obtain prior authorizations and document approvals in the registration system.

· Collect co-pays, deductibles, and outstanding balances; establish payment plans when needed.

· Explain insurance coverage, financial responsibility, and available financial assistance to patients.

· Register patients accurately, ensuring all demographic and insurance data is complete.

· Coordinate with clinical departments and physician offices to confirm procedure details and scheduling needs.

· Respond to patient inquiries regarding insurance, billing, and scheduling.

· Maintain accurate documentation of all verification and authorization activities.

· Reconcile daily cash drawer and ensure compliance with financial policies.

· Adhere to HIPAA and organizational confidentiality standards.

· Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION:

EXPERIENCE: One (1) year of experience in a healthcare setting preferred, especially in insurance verification or scheduling.

LICENSURE OR CERTIFICATION : None required.

KNOWLEDGE, SKILLS, AND ABILITIES:

· Knowledge of insurance plans, medical terminology, and healthcare billing practices.

· Strong communication and customer service skills.

· Proficiency in EHR systems and payer verification tools.

· Ability to multitask in a fast-paced environment.

· Attention to detail and accuracy in data entry.

· Basic computer and office equipment proficiency.