PATIENT ACCESS REPRESENTATIVE I-1

Medical University of South Carolina•Summerville, SC

17h•Onsite

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 supports payment for hospital and clinic services by checking available payment methods, verifying patient and insurance information, helping patients arrange payments or apply for assistance, collecting copayments and deductibles, and resolving basic billing inquiries. The representative collects and updates demographic and insurance information, obtains required documents and signatures, reviews regulatory forms, verifies coverage and authorization requirements, and performs patient identification and registration procedures. The role also screens patients for potential funding sources, communicates expected financial liability and payment arrangements, coordinates with clinical areas and providers on financial matters, and collects, posts, and reconciles payments. This position is scheduled for 36 hours per week on a day shift. It requires flexibility to work Friday, Saturday, and Sunday, as well as flex and staggered shifts, and involves substantial walking.

Requirements

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, including ability to work in multiple applications such as 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, including computer terminals, telephones, and copiers.
Knowledge of medical terminology.
Ability to handle multiple tasks simultaneously.
Ability to work weekends, including Friday, Saturday, and Sunday, and flexibility to work flex and staggered shifts.
Ability to perform substantial walking.
Associate degree, or high school diploma with two years of customer service experience.
High school diploma or equivalent (GED) with one year of customer service experience, as stated in the additional job description.

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 patient and guarantor demographic information in registration systems.
Obtain or explain required insurance cards, identification, forms, and signatures, and scan documents into the appropriate imaging system.
Complete Medicare Secondary Payer questionnaires when applicable and discuss Advanced Directives with patients, obtaining copies when available.
Review regulatory forms and information with patients, including privacy practices and billing information.
Verify insurance, coordination of benefits, and authorization or referral requirements using eligibility tools, payer websites, or telephone contact.
Follow patient identification procedures and apply identification bracelets when applicable.
Register patients during system downtime and enter registration data once systems become available.
Perform service recovery with patients and visitors as needed.
Verify financial information and determine coverage, pre-certification, and prior-authorization requirements.
Inform self-pay patients of prepayment requirements and screen patients for potential funding sources.
Prepare procedure estimates, calculate advance payment requirements, and explain acceptable arrangements for current and prior balances.
Refer potentially eligible patients to contract eligibility vendors and coordinate with clinical areas to resolve revenue-cycle issues and establish financial expectations.
Maintain current knowledge of requirements and procedures, meet performance metrics, read relevant communications, and attend required training.
Collect patient payments, provide receipts, and accurately complete required receipt fields.
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 secure a waiver for services when necessary.
Post payments accurately and reconcile receipts with cash collected, completing end-of-shift balancing forms.
Perform other appropriate duties in a competent, professional, and courteous manner.