Patient Access Rep Clinic Lead

CommonSpirit Health•Silverdale, WA

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 data 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 support a seamless patient intake experience. Responsibilities include registering patients and verifying demographic and insurance information; resolving or escalating registration issues; conducting routine insurance eligibility checks; scanning documents into the electronic medical record; recording non-clinical charges; collecting and reconciling payments; preparing for the next clinic day; and identifying and correcting registration issues before appointments. The role also processes referrals and pre-authorizations, communicates health plan and billing information, coordinates appointments and ancillary services, follows up with patients, and provides information and instructions related to referrals and care.

Requirements

One year of customer service work experience.
One year of work 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 patients and perform check-in and check-out, recording and verifying demographic, insurance, and other required information.
Follow registration procedures, identify deficiencies, resolve non-complex issues, and escalate issues when appropriate.
Conduct routine insurance eligibility verifications.
Copy and scan patient access documents into the correct location in the electronic medical record.
Record non-clinical charges from sources such as forms, depositions or attorney fees, and retail fees.
Collect and post co-payments, co-insurance, and other payments; reconcile payments, balance and close cash drawers, and complete end-of-day preparation.
Monitor and resolve registration and other front-end issues before patient visits, including correcting missing, erroneous, or incomplete information and resolving work-queue edits.
Process referrals and pre-authorizations for diagnostic testing, therapy, surgeries, procedures, and specialty care before the patient is seen.
Communicate health plan policies and procedures and answer routine patient questions about billing and insurance; obtain cost estimates when requested and refer complex questions to a Financial Counselor.
Notify physicians and patients when referrals are denied or when additional information or a second opinion is needed.
Update patient medical records and coordinate with referring clinics as needed to support patient care.
Schedule and coordinate appointments and ancillary services, including appointments involving multiple 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 is needed.
Arrange for special or ancillary patient needs, including transportation and interpreters.
Work with clinic teams, patients, and employers to provide instructions and information about referral appointments, testing, financial policies, registration requirements, and relevant educational opportunities.