PATIENT ACCESS REPRESENTATIVE I-1

Medical University of South Carolina•Summerville, SC

About The Position

The Patient Access Representative reports to the Patient Access Manager and provides customer service while preparing and verifying patient accounts for inpatient and outpatient billing. The role verifies patient, guarantor, and insurance information; reviews available payment methods; helps patients arrange payments or apply for assistance programs; collects copayments and deductibles; and responds to basic billing inquiries. The representative completes registrations and updates demographic and insurance data, reviews required forms, verifies coverage and authorization requirements, and screens patients for potential funding sources. The role also explains financial expectations, prepares procedure estimates, collects and posts payments, and reconciles receipts and cash. Registration information must be complete and accurately entered in the required systems, with incomplete edits updated within eight hours of admission. The position requires customer-facing work, substantial walking, use of office and registration equipment, and flexibility to work weekends and flex or staggered shifts.

Requirements

High school diploma or equivalent (GED).
At least one year of customer service experience according to the additional job description; the essential requirements section specifies two years of customer service experience.
Excellent customer service skills.
Ability to receive and communicate detailed information orally and in writing.
Ability to use professional negotiation techniques to collect amounts owed by patients or guarantors.
Knowledge of insurance plans and benefits.
Computer literacy and ability to use multiple applications, including Microsoft Office.
Typing speed of 35–40 words per minute; certified typing test results are required.
Eye-hand coordination and manual dexterity.
Ability to use office equipment such as computer terminals, telephones, and copiers.
Knowledge of medical terminology.
Ability to handle multiple tasks simultaneously.
Availability to work Friday, Saturday, and Sunday, and flexibility to work flex and staggered shifts.
Ability to perform substantial walking.
Ability to perform job functions while standing, sitting, and walking frequently; climb stairs infrequently; work indoors continuously and at elevated areas frequently; and work in confined or cramped spaces infrequently.
Ability to kneel and squat infrequently, bend at the waist frequently, perform repetitive upper-extremity motions frequently, and reach in all directions frequently.
Good finger dexterity; ability to fully use both legs and both hands/arms; and ability to lift and carry 15 pounds unassisted infrequently, including lifting from the floor to 36 inches and from 36 inches to overhead.
Ability to maintain specified vision, color discrimination, depth perception, hearing, gross and fine motor, latex-safe work, and tactile capabilities; additional sensory and respirator qualifications apply to selected positions.

Nice To Haves

Patient Access Certification.
One year of relevant experience in a medical office or hospital.
Ability to interpret and apply financial procedures and regulations.
Previous experience with hospital information systems or word processing.

Responsibilities

Confirm, enter, and update demographic information for patients and guarantors in registration systems.
Obtain or explain insurance cards, identification, and required signatures; scan documents into the appropriate imaging system.
Complete the Medicare Secondary Payer questionnaire for applicable patients and discuss advance directives, obtaining a copy when available.
Review regulatory forms and patient information, including privacy practice notices and billing information.
Verify insurance eligibility, coordination of benefits, and authorization or referral requirements using payer websites, real-time eligibility tools, or phone contact.
Follow patient identification procedures and apply identification bracelets when applicable.
Register patients during system downtime and enter data once systems become available.
Provide service recovery for patients and visitors as needed.
Verify financial information and pre-certification or prior-authorization requirements.
Inform self-pay patients of prepayment requirements and screen them for possible funding sources.
Prepare procedure estimates, calculate advance payments, and explain acceptable payment arrangements for current and previous balances.
Refer potentially eligible patients to contract eligibility vendors and coordinate with clinical areas regarding financial expectations and revenue-cycle issues.
Maintain current knowledge and skills, meet applicable performance metrics, read department communications, and attend required training.
Collect patient payments, issue receipts, and accurately complete required documentation.
Contact patients before their date of service to explain expected financial liability, educate them about benefits, and accept payment by phone when agreed.
Coordinate with providers when payment cannot be collected and obtain a waiver for services when necessary.
Post payments accurately and reconcile receipts with collected cash, completing end-of-shift balancing forms.
Complete required Medicare Secondary Payer questionnaires for Medicare patients before discharge to comply with CMS requirements.
Complete assigned MyQuest (now OurDay) training modules.
Process complete registrations in required systems and use the hospital registration system and associated peripheral equipment.
Process registrations through the various workflows used by the department.
Complete registration information in the required format and update incomplete registration edits within eight hours of admission.
Perform other appropriate duties in a competent, professional, and courteous manner.