Patient Access Representative III - OC

City of Hope•Irvine, CA

About The Position

The Patient Access Representative III plays a critical role on the care team by providing patients with a compassionate experience when checking in and out of appointments, coordinating future visits, and responding to inbound calls. The role uses independent judgment, customer service, communication, and multitasking skills to coordinate patient appointments across multiple hospital departments. It uses telecommunications and computer information systems to create accounts, verify information and insurance, collect co-pays, and schedule or reschedule complex appointments. The representative also communicates regularly with physicians, nurses, care team members, and departments to support teamwork and seamless clinic operations. The position handles registration and scheduling across clinics, ancillary areas, and the hospital, including preregistration, consents, appointment coordination, accurate demographic and insurance data entry, legal documentation, cash collection, patient pricing estimates, and ETC admission. It reviews account documentation, verifies insurance eligibility and authorization, supports financial clearance, and connects patients with financial counseling and assistance resources. It also coordinates test orders and related documentation, provides patient instructions, and screens ordered tests for Medicare coverage criteria. The representative greets and assists patients and visitors, serves as a liaison between patients and support staff, and works effectively with colleagues and providers. The role requires managing changing priorities under stressful conditions, responding professionally to difficult situations, recognizing and acting on high-priority situations, and escalating issues that may affect patient care. The representative maintains department productivity, accuracy, quality assurance, and knowledge of applicable policies, procedures, and standard work.

Requirements

High school diploma or equivalent.
Two years of related experience registering and scheduling complex patient appointments in a clinic or hospital setting.
Medical terminology experience required.

Responsibilities

Register and preregister patients, obtain consents, and schedule all appointment types across clinics, ancillary areas, and the hospital.
Create preregistration records and link them to scheduled appointments, ensuring the correct visit encounter type is associated with each appointment.
Coordinate appointments proactively with other functional areas and maintain department productivity, accuracy, and quality standards.
Accurately enter patient demographic and insurance information; complete required legal documents and obtain and scan related documents.
Perform cash collection, provide patient pricing estimates, and handle ETC admission duties.
Review account documentation and meet financial protocols while facilitating access to services at City of Hope facilities.
Verify insurance eligibility, confirm authorization before patients proceed to service areas, and escalate unsecured financial accounts to management.
Provide itineraries, advance beneficiary notices, and written instructions for tests and procedures when applicable.
Seek assistance from Financial Counselors to maintain patient flow, resolve financial issues, and support financial clearance.
Explain the Financial Assistance policy and application process, provide applications to uninsured patients, and screen ordered tests for Medicare coverage criteria, communicating concerns to physicians or the ABN Specialist.
Create authorization requests when applicable; send diagnostic test orders to the appropriate department with documentation showing the date of service and visit number.
Greet and assist patients and visitors, serve as a liaison between patients and support staff, and build effective working relationships across the organization.
Manage changing priorities, remain composed and professional under pressure, take immediate action in high-priority situations, resolve service issues, and escalate unresolved issues according to departmental guidelines.
Maintain knowledge of department policies, procedures, and standard work and meet productivity and accuracy standards.