Patient Access Rep Clinic Lead
About The Position
The Patient Access Representative Clinic Lead manages administrative duties for the patient intake process in a clinic, following established guidelines. The role interacts with patients in person and by phone to facilitate check-in and check-out, collect information and payments, validate insurance, schedule appointments, and process referrals and authorizations. Success requires critical thinking, strong customer service, and knowledge of insurance, billing, and medical terminology to provide a seamless patient intake experience. The position registers and checks patients in and out, verifies demographic and insurance information, conducts routine eligibility checks, scans documents into the electronic medical record, enters non-clinical charges, and collects and reconciles payments. It also monitors and corrects registration and insurance issues, resolves work-queue edits, processes referrals and pre-authorizations, and communicates coverage and billing information to patients. The role coordinates appointments, ancillary services, and patient requirements such as transportation and interpreters; follows up on missed appointments and referral needs; and helps ensure patients receive appropriate instructions and information about their appointments, services, financial policies, and registration requirements.
Requirements
- One year of customer service work experience.
- One year of experience as a Patient Access Representative II (or equivalent), or a combination of experience or education that demonstrates the capability to meet the position requirements.
Nice To Haves
- Two years of customer service work experience.
- Healthcare or Call Center experience.
- Previous lead or supervisory experience.
Responsibilities
- Register and check patients in and out; record and verify demographic, insurance, and other required information.
- Conduct routine insurance eligibility verifications and copy or scan patient access documents into the correct location in the electronic medical record.
- Record non-clinical charges and collect, post, reconcile, and balance patient payments, including closing out cash drawers at the end of the day.
- Complete outstanding tasks and prepare or assign preparation work for the next clinic day.
- Monitor and resolve registration, insurance, and other front-end issues before patient visits; update missing, erroneous, or incomplete information and resolve work-queue edits.
- Process referral orders and pre-authorizations before patients are seen, escalating insurance verification when needed.
- Explain health plan policies, billing matters, insurance coverage, and non-complex cost estimates to patients; refer complex questions to a Financial Counselor.
- Notify physicians and patients when referrals are denied or additional information or a second opinion is needed; update patient records and coordinate with referring clinics as appropriate.
- Schedule and coordinate patient appointments and ancillary services, including appointments across providers or clinics when assigned to Call Center work.
- Contact patients to confirm referral appointments or reschedule missed or cancelled appointments; document no-show reasons and notify management when further action may be needed.
- Arrange for special or ancillary patient needs, including transportation and interpreters.
- Coordinate patient instructional and educational activities and provide information about referral appointments, testing, financial policies, and registration requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
