Patient Access Representative

Job Description

Job Description

Minimum 1 year of medical receptionist, medical front-office, Patient Access, or closely related healthcare experience.
• Experience obtaining or processing insurance pre-authorizations for wound care, surgical, and/or other medical procedures.
• Experience performing insurance eligibility and benefits verification.
• Experience supporting patients in a healthcare front-office or Patient Access environment.
• Experience with appointment and/or medical procedure scheduling preferred.
• Experience in wound care, dermatology, surgery, radiology/imaging, or another procedure-focused specialty is strongly preferred.

Working knowledge of medical terminology.
• Experience using electronic medical records and healthcare registration systems.
• Epic and/or iHEAL experience preferred.
• Experience with insurance verification, eligibility, and prior authorization workflows.
• Experience managing electronic work queues and following up on outstanding insurance, authorization, or patient-account items.
• Strong computer, data-entry, and documentation skills.
• Ability to accurately enter and maintain demographic, insurance, authorization, scheduling, and patient account information.
• Excellent telephone etiquette and strong verbal communication skills.
• Strong written communication skills.
• High level of attention to detail and accuracy.
• Strong organizational and prioritization skills.
• Ability to manage multiple responsibilities in a busy, patient-facing healthcare environment.
• Professional, compassionate, and patient-centered approach to service.
• Ability to work independently while collaborating effectively with clinical and administrative teams.
• Comfortable communicating insurance coverage, authorization status, and patient financial responsibilities.
• Ability to maintain confidentiality and handle sensitive patient information appropriately.
• Serve as a professional front-office point of contact for patients, families, visitors, providers, insurance carriers, and other healthcare partners.
• Greet and assist patients and visitors courteously while supporting a positive patient experience.
• Answer, screen, and direct incoming and external telephone calls promptly and professionally.
• Complete patient registration and maintain accurate demographic, insurance, and account information.
• Verify insurance eligibility, coverage, benefits, and other applicable payer information.
• Obtain and/or process required pre-authorizations for wound care, surgical, and other applicable medical procedures.
• Follow up on outstanding authorizations and insurance-related issues to support timely patient care and appropriate reimbursement.
• Identify and help resolve insurance verification, eligibility, and authorization discrepancies.
• Document insurance verification and authorization information accurately in applicable systems.
• Maintain accurate patient and account documentation within Epic and iHEAL.
• Manage assigned work queues related to registration, insurance verification, authorization, scheduling, and account follow-up.
• Assist with scheduling patient appointments, procedures, and related services as applicable.
• Coordinate with physician offices, insurance carriers, clinical staff, and other departments when additional information, orders, or documentation are needed.
• Communicate insurance coverage, authorization status, and patient financial responsibilities clearly and professionally.
• Collect or process patient payments and copays according to established departmental procedures, as applicable.
• Scan and maintain required patient, insurance, authorization, and supporting documentation within the electronic medical record.
• Review account information for completeness and accuracy and correct identified errors when appropriate.
• Independently prioritize daily responsibilities to meet patient needs, departmental deadlines, and productivity expectations.
• Maintain confidentiality and adhere to all applicable privacy, compliance, and departmental policies and procedures.
• Support a collaborative, professional, and patient-centered work environment.