Patient Access Rep Clinic
About The Position
The Patient Access Representative manages administrative duties for the patient intake process in a clinic while adhering to 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 representative registers patients and verifies demographic, insurance, and other information; conducts routine insurance eligibility checks; scans and records documents and non-clinical charges; handles payments; and reconciles cash drawers. The role researches and corrects registration issues, completes referrals and pre-authorizations, answers patient questions about billing and insurance, coordinates appointments and ancillary services, and arranges special patient needs such as transportation and interpreters.
Requirements
- At least one year of customer service work experience.
- Strong customer service and critical-thinking skills.
- Knowledge of insurance, billing, and medical terminology.
Nice To Haves
- Two years of customer service work experience.
- Healthcare experience.
- Call center experience.
Responsibilities
- Register patients and perform patient check-in and check-out.
- Record and verify demographic, insurance, Workers’ Compensation, and other third-party liability information, ensuring registration requirements are met and escalating issues as appropriate.
- 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, handle, and reconcile payments, including co-payments, co-insurance, other fees, and cash payments.
- Perform end-of-day payment reconciliation, balance and close cash drawers, and complete or assign outstanding tasks and preparation for the next clinic day.
- Monitor and research registration and insurance issues before patient visits; make front-end corrections, update missing or erroneous information, and resolve work-queue edits.
- Process referral orders and pre-authorizations, verifying eligibility and completing requirements before patients receive services.
- Explain health plan policies, billing matters, insurance benefits, and cost estimates to patients and communicate relevant information to employees and physicians.
- Notify physicians and patients when referrals are denied or when a second opinion or additional information is needed; update patient medical records as necessary.
- Coordinate with referring clinics and schedule patient visits and ancillary services, including appointments across providers and clinics when assigned to a call center work unit.
- Contact patients to confirm referral appointments or reschedule missed or cancelled appointments, document no-show reasons, and notify management of policy violations requiring further action.
- Arrange special or ancillary patient requirements, including transportation and interpreters.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
