Patient Access Representative

Job Summary

The Patient Access Representative will be responsible for confirming demographic information, insurance verification, scheduling appointments, collecting payments and providing excellent customer service at all times. The representative will also manage and improve provider schedules, working closely with clinical staff and ancillary departments within the healthcare center. The role leads the organization in building trust, comfort and rapport with patients and prospective patients.

• Schedules patient appointments and enters required information in the computer system in an accurate and timely manner.
• Obtains demographic, insurance and financial information from patient or guarantor and enters it efficiently into the computer system.
• Explains all required forms to the patient or guarantor and obtains the necessary signatures.
• Ensures medical necessity compliance by obtaining necessary data and communicating information to patient or guarantor.
• Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility.
• Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required time frames.
• Posts payments in the computer system and generates the appropriate patient receipts.
• Monitors reviews and resolves patient account issues on assigned reports.
• Communicates in an effective and professional manner with physicians, ancillary departments, nursing staff, physicians' office staff, insurance companies, as well as patients and their families (all Patient Access customers). Completes thorough and accurate documentation.
• Meets metrics and completes reports as assigned.
• Participates in projects and meetings, and completes other tasks assigned by management.

• One year of work experience in a medical setting, or three years of customer service/receptionist experience preferred.
• Must have excellent customer service skills demonstrating strong verbal, written and communication skills along with active listening skills.
• Comfortable working in a fast‑paced environment.
• Must have a strong work ethic and the ability to handle a variety of tasks.
• Demonstrates initiative and works cooperatively to identify and implement quality improvements.
• Demonstrates teamwork and respect for fellow staff, team members, patients, and community partners.
• Exercises problem‑solving and conflict resolution skills when handling patient or staff complaints.
• Cultural sensitivity and demonstrated ability to work with diverse groups of people.
• Highly professional, personable and must share the organization’s mission to patient care.
• Familiarity with office machines, such as computers, faxes, photocopiers.
• Knowledge of basic math, billing and insurance principals.
• Must be flexible to grow with the organization and willing to work alternative shifts, weekends, and travel to multiple locations as needed.
• Practices confidentiality and privacy protocols in accordance with clinic and HIPAA regulations.

Minimum required education: high school diploma or GED certificate.

• Typing ability required.
• Bilingual in Spanish strongly preferred.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Stand, walk, sit; use hands to finger, handle and feel objects, tools and controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch and crawl; talk and hear; taste and smell.
• Occasionally lift and/or move up to 30 pounds.
• Specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

The employee is not exposed to weather conditions. The noise level in the work environment is usually moderate. The employee will be assigned to a regular work schedule, which may include hours before 8:00 am, after 5:00 pm, and as determined by department needs and requirements.