Patient Access Rep Clinic
About The Position
The Patient Access Representative 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 support a smooth, high-quality patient intake experience. The representative registers patients, verifies and updates demographic and insurance information, handles payments, reconciles cash drawers, resolves registration issues and work-queue edits, and prepares for upcoming clinic days. The role also processes referrals and pre-authorizations, answers patient questions about billing and insurance, coordinates appointments and ancillary services, updates electronic medical records, and arranges for patient needs such as transportation or interpreters.
Requirements
- At least one year of customer service work experience.
- No additional requirement upon hire is specified.
Nice To Haves
- Two years of customer service work experience.
- Healthcare or Call Center experience.
Responsibilities
- Register patients and perform check-in and check-out.
- Record and verify demographic, insurance, Workers’ Compensation, and other third-party liability information; ensure registration requirements are satisfied and resolve or escalate deficiencies.
- Conduct routine insurance eligibility verifications and copy or scan patient-access documents into the appropriate location in the electronic medical record.
- Record non-clinical charges, collect and post payments, and handle payments according to cash-handling procedures.
- Collect applicable co-payments, co-insurance, and other fees at check-in or check-out when appropriate.
- Reconcile payments at the end of the day, balance and close cash drawers, complete outstanding tasks, and prepare or assign preparation work for the next clinic day.
- Monitor and research patient registration and insurance issues before visits; correct missing, erroneous, or incomplete information and resolve work-queue edits.
- Process referral orders and pre-authorizations, ensuring eligibility checks and required authorizations are completed before the patient is seen.
- Complete referrals or pre-authorizations for diagnostic testing, therapy, surgeries, procedures, and specialty care according to requirements and patient preferences.
- Explain health plan policies, procedures, and benefit coverage; answer billing and insurance questions and obtain cost estimates when requested.
- Notify physicians and patients when a referral is denied or when a second opinion or additional information is needed.
- Update patient medical records and copy or scan documents into the appropriate electronic medical record location.
- Coordinate with referring clinics as needed to support patient care.
- Schedule and coordinate patient appointments and ancillary services, including appointments across multiple providers and clinics when assigned to a Call Center work unit.
- Identify patients who need contact to confirm a referral appointment and contact them according to established procedures.
- Follow up with patients to reschedule missed or cancelled appointments, document no-show reasons, and notify management when policy violations require further action.
- Arrange special or ancillary patient needs, including transportation and interpreter services.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
