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 involves interacting with patients in person and by phone to facilitate check-in and check-out, collect information and payments, verify 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 high-quality patient intake experience. The representative registers and checks patients in and out; records and verifies demographic, insurance, and other information; performs routine insurance eligibility checks; scans patient-access documents into the electronic medical record; records non-clinical charges; and collects, posts, and reconciles payments. The role also includes resolving registration issues and work-queue edits, preparing for upcoming clinic days, and ensuring patient records and eligibility information are complete. The representative processes referrals and pre-authorizations, communicates health-plan policies and billing or insurance information to patients and others, obtains cost estimates when requested, and notifies patients and physicians when referrals are denied or require additional information. The role coordinates appointments and ancillary services, follows up with patients about appointments, documents missed visits, and arranges support such as transportation or interpreters when needed.
Requirements
- At least one year of customer service work experience.
- Knowledge of insurance, billing, and medical terminology.
- Strong customer service and critical-thinking skills.
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, recording and verifying demographic, insurance, and other required information.
- Follow registration procedures, identify deficiencies, resolve non-complex issues, and escalate other issues to appropriate staff.
- Conduct routine insurance eligibility verifications and scan patient-access documents into the correct locations in the electronic medical record.
- Record non-clinical charges from sources such as form completion, 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 insurance issues before patient visits, make front-end corrections, update incomplete or inaccurate information, and resolve work-queue edits.
- Process referrals and pre-authorizations for diagnostic testing, therapy, surgeries, procedures, and specialty care before patients are seen.
- Explain health-plan policies, billing, insurance, and benefit coverage; obtain cost estimates when requested and answer patient questions.
- Notify physicians and patients when referrals are denied or require a second opinion or additional information; update medical records and coordinate with referring clinics as needed.
- 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, reschedule missed or cancelled appointments, and document no-show reasons according to procedures.
- 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
