Patient Access Rep – TMCOne -Insurance Verification Rep

Patient Access Rep I – TMCOne
-Insurance Verification Rep

Job Category :
Clerical

Schedule :
Full time

Shift : 1 - Day Shift

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.

• 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.

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

None required.

• 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.