PATIENT ACCESS REPRESENTATIVE I-4

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 reviews available payment methods, verifies patient and insurance information, helps patients arrange payments or apply for assistance programs, collects copayments and deductibles, and responds to basic billing inquiries. The representative obtains and updates demographic and insurance information, gathers required identification and forms, completes applicable Medicare Secondary Payer questionnaires, reviews regulatory information with patients, verifies insurance eligibility and authorization requirements, and registers patients using the applicable systems and procedures. The role also assesses coverage and potential funding sources, explains expected financial responsibility, prepares estimates, coordinates financial expectations with clinical areas, and collects, posts, and reconciles patient payments. The position requires customer-service and communication skills, the ability to handle multiple tasks, substantial walking, and the ability to work Fridays, Saturdays, and Sundays on flexible or staggered shifts. Physical requirements include frequent standing, sitting, walking, bending, reaching, and repetitive hand and arm movements, as well as occasional lifting and carrying up to 15 pounds. The role also involves working indoors and using office and registration equipment.

Requirements

High school diploma or equivalent (GED).
At least one year of customer service experience is stated in the additional job description; the essential requirements state high school diploma with two years of customer service experience.
Excellent customer service skills.
Ability to receive and express detailed information through oral and written communication.
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 use multiple applications, including Microsoft Office.
Typing speed of 35–40 words per minute; certified typing test results required.
Ability to handle multiple tasks simultaneously.
Ability to work Fridays, Saturdays, and Sundays, and to work flexible and staggered shifts.
Ability to perform substantial walking.
Ability to interpret and apply financial procedures and regulations is preferred in the additional job description.
Ability to use office equipment, including computer terminals, telephones, and copiers.
Knowledge of medical terminology.
Eye-hand coordination and manual dexterity.
Ability to meet the stated physical and sensory demands, including frequent standing, sitting, walking, bending, reaching, and repetitive movements; occasional lifting and carrying up to 15 pounds; and continuous indoor work.

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

Obtain, confirm, enter, and update patient and guarantor demographic and insurance information in registration systems.
Obtain and explain insurance cards, identification, and required signatures; scan documents into the appropriate imaging system.
Complete Medicare Secondary Payer questionnaires for applicable patients and discuss advance directives when appropriate.
Review regulatory forms and information, including privacy practice notices and billing information.
Verify insurance eligibility, coordination of benefits, and authorization or referral requirements through payer tools, websites, or phone calls.
Identify patients accurately and apply identification bracelets when applicable; follow downtime registration procedures and enter data when systems become available.
Provide service recovery for patients and visitors when needed.
Verify financial information and pre-certification or prior-authorization requirements, and screen self-pay patients for prepayment requirements or potential funding sources.
Prepare procedure estimates, calculate advance payment requirements, explain payment arrangements, and refer potentially eligible patients to funding vendors.
Coordinate with clinical areas to establish patient financial expectations and resolve revenue-cycle issues.
Maintain knowledge of applicable requirements and skills, meet performance metrics, read department communications, and attend required training.
Collect patient payments, issue receipts, and contact patients before services to explain expected financial responsibility and discuss benefits and payment.
Coordinate with providers when patient payment cannot be collected and obtain service waivers when necessary.
Post payments accurately and reconcile receipts with cash, completing required balancing forms at the end of each shift.
Complete required Medicare Secondary Payer questionnaires, MyQuest training modules, and registrations in required systems.
Maintain registration quality by updating incomplete edits within eight hours of admission.
Perform other appropriate duties competently, professionally, and courteously.