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 checkout, collect and verify 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 provide a seamless patient intake experience. The representative registers and checks patients in and out, verifies demographic and insurance information, scans documents into the electronic medical record, records non-clinical charges, collects and posts payments, and reconciles cash drawers and daily payments. The role identifies and resolves registration issues, checks insurance eligibility, corrects front-end records, resolves work-queue edits, and completes preparation for upcoming clinic days. The representative processes referrals and pre-authorizations, explains health plan policies and benefits, responds to billing and insurance questions, obtains and explains cost estimates, and communicates referral denials or requests for additional information. The role also coordinates appointments and ancillary services, follows up with patients about referrals and missed appointments, and arranges special needs such as transportation and interpreters.
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 and check patients in and out, verifying demographic, insurance, and other required information and resolving or escalating registration deficiencies.
- Conduct routine insurance eligibility verifications and ensure checks are completed before appointments where possible.
- Copy and scan patient access documents into the appropriate locations in the electronic medical record and update patient records as needed.
- Record non-clinical charges, collect payments and fees, post payments to patient accounts, and reconcile payments and cash drawers at the end of the day.
- Monitor and resolve registration and front-end issues, correct missing or erroneous information, resolve work-queue edits, and prepare for the next clinic day.
- Process referrals and pre-authorizations for diagnostic testing, therapy, surgeries, procedures, and specialty care before the patient is seen.
- Explain health plan policies, insurance benefits, billing information, and cost estimates to patients; communicate relevant information to employees, physicians, and members.
- Notify physicians and patients about denied referrals or requests for a second opinion or additional information.
- Coordinate patient appointments and ancillary services, including scheduling across providers and clinics when assigned to Call Center work.
- Contact patients to confirm referral appointments and reschedule missed or cancelled appointments; document no-show reasons and notify management when further action is needed.
- Arrange special or ancillary patient requirements, including transportation and interpreters.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
