Patient Access Representative - Ambulatory

FMOLHS•Jackson, MS

About The Position

The Patient Access Representative is responsible for accurately registering patients in the electronic medical record, validating patient information, verifying insurance coverage, collecting required payments, and supporting a high-quality patient experience. The role follows established guidelines and works under close supervision. The representative welcomes and assists patients and families, explains collection and billing procedures and anticipated charges, addresses questions, and helps patients access information and available health care resources. The role also supports patient scheduling and flow, processes referrals and records, performs clerical duties, and works with clinical staff to coordinate referrals in accordance with payor requirements. Additional duties include researching billing edits and denials, entering and processing charges, reviewing diagnosis and procedure codes, collecting and reconciling payments, managing cash securely, and meeting site collection goals. The representative may provide backup coverage and training and support clinic, hospital, and health system operational improvement initiatives.

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 and demonstrate proficiency in Epic during the introductory period.

Responsibilities

Courteously explain collection and billing procedures and anticipated charges to patients.
Welcome patients and families and respond appropriately to their questions and concerns.
Inform patients of their rights and Advance Directives upon request.
Accurately obtain, update, and maintain patient and insurance information in the computer system.
Register patients in Epic and manage patient flow through the clinic.
Review patient accounts, determine financial responsibility, and arrange payment plans.
Assist patients with access to government and community resources and information such as MyChart.
Coordinate referrals with physicians, nurse practitioners, and nursing staff in accordance with payor requirements.
Enter patient charges and process referral documentation accurately.
Schedule and reschedule patient appointments and perform clerical duties, including answering calls and retrieving and filing records.
Research claim edits, denials, and billing discrepancies and resolve them within the stated timeframes.
Key charges and process batches daily; prepare bank and deposit summaries after balancing payments and receipts.
Review diagnosis and procedure codes and enter data at the point of service.
Verify and collect patient payments, verify account balances, reconcile the daily cash fund, and manage cash securely.
Maintain general knowledge of health plans, including co-pays, deductibles, and co-insurance, and meet site collection goals.
Provide backup support for clinic colleagues, support operational improvement initiatives, and provide training or orientation when assigned.