Patient Access Representative

Job Title:         Patient Access Representative 

Department:    Administration-Clinical 

Supervisor:     Director, Revenue Cycle 

FLSA Status:   Full-time, Non-Exempt 

Summary

The Patient Access Representative performs all receptionist and clerical duties at the front desk and also assists the medical professionals as needed in providing comprehensive services to patients. He/she is the first point of contact for patient visits, telephone inquiries, and problem resolution. The Patient Access Representative must demonstrate excellent customer service, accuracy, and reliability. He/she is responsible for arranging for efficient and accurate collection of information for orderly registration of pediatric, adult, and geriatric patients. The Patient Access Representative collects and distributes patient information, billing information, and collection information and provides financial estimates and collects applicable patient financial liability. The Patient Access Representative positively affects the patient’s experience and makes patients and families aware of hospital policies and procedures. The duties of this position require the exercise of courtesy in speaking with patients, families, and others to maintain sound community relations.

Essential Duties and Responsibilities

Front Office and Patient Interaction: 

• Greets visitors and callers with excellent customer service, while handling their inquiries, taking messages and referring them to the appropriate medical professional
• Schedules patients’ appointments by phone and in person
• Conducts appointment reminder calls patients 24 hours prior to appointment 
• Records telephone encounters in the Electronic Medical Records system
• Performs detail insurance verification and eligibility check for upcoming appointments by obtaining the necessary information before the appointment  
• Assists patients with application for sliding fee scale and any other forms
• Collects and records payments in the EMR system and maintains petty cash
• Opens and distributes mail to the appropriate persons and prepares outgoing mail in a timely manner

Benefit Coordination: 

• Coordinates insurance benefits and consults patients on financial responsibility
• Calls insurance companies to verify patients’ benefits, notifying patients 
• Input benefit information in the EMR system, as well as upload appropriate benefit information into patient account
• Consult patients of financial responsibility
• Follow up on x-rays and Perio charts to billing company on behalf of the medical professionals 
• Ensure prior authorizations are on file prior to patients’ appointment to prevent a delay in services

Core Responsibilities:

• Responsible for proper handling of medical records in accordance with company policy and HIPAA standards. 
• Follow policy on Medical Record Release and send records to requesting party.
• Highly skilled in reasoning and working with the public to secure positive outcomes required.
• Ability to travel between practices as needed.
• Demonstrated time management and problem-solving skills, showing quick adaptation in a variety of situations.
• Must execute critical thinking, sound judgment, and cultural awareness skills.

Qualifications, Education and/or Experience

• Minimum of 2 years’ experience in a customer service environment, health center experience is a plus
•  Customer service experience and demonstrated work experience with underserved populations.

• Proficient in MS Office, electronic health information technology, and medical terminology
• Ability to use a multiline phone system and take/route messages
• Ability to perform outreach and related responsibilities as required to support the health center operations with emphasis on geriatrics patients.
• Ability to maintain confidentiality of all patient information verbal and written. 
• Must be able to operate standard office equipment such as fax/copier/scanner, digital postage, computers, label maker, computer system

LANGUAGE SKILLS: Must possess above average command of speaking and writing skills.
 
REASONING ABILITY: Must be able to exercise sound judgment and concrete thinking when on the spot decision making is required. Ability to seek supervision for emergencies and unusual circumstances. Must be able to participate in regularly scheduled meetings. 

A list of physical demands, equipment, & work environment demands can be reviewed in Human Resources. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.