Patient Access Representative - Ambulatory

FMOLHS•Jackson, MS

About The Position

The Patient Access Representative accurately registers patients in the electronic medical record, validates patient information, verifies insurance coverage, collects required payments, and helps ensure a high-quality patient experience. The role follows established guidelines and works under close supervision. The representative welcomes and assists patients and families, explains billing and collection procedures and anticipated charges, answers questions, maintains accurate patient and insurance records, and supports patient access to services and information such as MyChart. The position also supports patient flow by scheduling appointments, processing referrals, performing clerical and records duties, and coordinating with clinical staff and other providers. The role researches billing and claim discrepancies, enters and processes charges, reviews diagnosis and procedure codes, collects and reconciles payments, manages cash securely, and maintains general knowledge of health plan requirements. Other duties include backing up clinic staff, supporting operational improvement initiatives, and providing training or orientation when assigned.

Requirements

High school diploma or equivalent.
Six months of experience in a customer service or front desk role, or graduation from a front office or medical office program. A bachelor's degree may substitute for experience.
Professional demeanor and excellent customer service skills.
Ability to multitask and use critical thinking.
Demonstrated computer literacy.
Ability to learn Epic and demonstrate proficiency during the introductory period.

Responsibilities

Courteously explain collection and billing procedures and anticipated charges to patients.
Welcome patients and families, address their questions and concerns, and provide information about patient rights and advance directives upon request.
Accurately obtain, update, and maintain patient and insurance information and records in the clinic computer system.
Register patients in Epic and manage patient flow through the clinic.
Review patient schedules and accounts, determine financial responsibility, and arrange payment plans.
Assist patients with access to government and community resources and information, including MyChart.
Coordinate with physicians, nurse practitioners, and nursing staff to ensure referrals are completed according to payer requirements and in a timely manner.
Enter patient charges as necessary.
Process referral documentation and schedule or reschedule appointments to support effective patient flow.
Perform clerical duties, including answering telephone calls, retrieving medical records, recording data, typing memorandums, and filing patient charts and information.
Research claim edits, denials, billing information, and discrepancies, and resolve them within the specified timeframes.
Key charges and process batches daily; prepare bank and deposit summaries after balancing payments to receipts.
Review diagnosis and procedure codes for accuracy and enter data at the point of service.
Verify and collect patient payments, verify account balances, collect outstanding balances, and reconcile the daily cash fund.
Maintain general knowledge of health plans, including copayments, deductibles, and coinsurance.
Manage cash according to established policies and procedures, ensuring accurate account credits and secure handling.
Meet site collection goals.
Act as a backup for other clinic staff, support operational improvement initiatives, and provide training or orientation when assigned.
Perform other duties as assigned.