PATIENT ACCESS REPRESENTATIVE I-3

Medical University of South Carolina•Ashley, WV

About The Position

The Patient Access Representative reports to the Patient Access Manager and provides customer service while verifying and preparing patient accounts for inpatient and outpatient billing. The role verifies available payment methods and patient and insurance information; helps patients establish payment arrangements or apply for assistance programs; assists with copayments and deductibles; and addresses basic billing inquiries. The representative obtains and updates patient demographic and insurance details, gathers required identification, insurance cards, signatures, and forms, and stores documentation in the appropriate system. Duties include completing Medicare Secondary Payer questionnaires when applicable, discussing advance directives, reviewing regulatory and billing notices, verifying insurance eligibility and coordination of benefits, and obtaining required authorizations or referrals. The role also supports patient identification, registration downtime procedures, and service recovery. The representative verifies coverage and financial information, screens self-pay patients for potential funding sources, prepares procedure estimates, explains payment expectations, and coordinates with clinical areas on financial and revenue-cycle issues. The role collects and posts patient payments, issues receipts, reconciles cash and receipts, and completes end-of-shift balancing forms. The position requires customer service, communication, insurance and medical terminology knowledge, computer skills, and the ability to manage multiple tasks. Weekend availability and flexibility for staggered or flexible shifts are required.

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 and ability to work across 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.
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, as stated in the essential education requirements.
High school diploma or equivalent (GED) with one year of customer service experience, as stated in the additional job description.
Ability to meet the stated physical requirements, including frequent standing, sitting, walking, bending, reaching, and repetitive hand and arm motions; occasional lifting and carrying up to 15 pounds; and continuous indoor work.

Nice To Haves

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

Responsibilities

Obtain, confirm, enter, and update patient and guarantor demographic and insurance information in registration systems.
Secure and explain insurance cards, identification, signatures, and required forms; scan documentation into the appropriate system.
Complete Medicare Secondary Payer questionnaires when applicable and discuss advance directives with patients.
Review regulatory forms and information with patients, including privacy practice and billing information.
Verify insurance eligibility and coordination of benefits and obtain required authorizations or referrals.
Follow patient identification procedures, including applying identification bracelets when applicable.
Register patients during system downtime and enter data once systems become available.
Perform service recovery with patients and visitors when needed.
Verify financial information and pre-certification or prior-authorization requirements through insurers or verification technology.
Inform self-pay patients of prepayment requirements and screen them for potential 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 to resolve revenue-cycle issues and establish financial expectations.
Maintain current knowledge of facility, unit, and payer requirements, performance metrics, communications, and required training.
Collect patient payments, accurately complete receipts, and inform patients of expected financial liability before service when applicable.
Explain patient benefits and accept payment by phone when agreed to by the patient.
Coordinate with providers when payment cannot be collected and obtain service waivers when necessary.
Post payments accurately and reconcile receipts with cash collected, completing required end-of-shift balancing forms.
Perform other position-appropriate duties in a competent, professional, and courteous manner.