PATIENT ACCESS REPRESENTATIVE I-4

Medical University of South Carolina•Ashley, WV

22h

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 to maximize payment for hospital and clinic services. The role reviews available payment methods, verifies patient and insurance information, helps patients arrange payments and apply for assistance programs, collects copayments and deductibles, and resolves basic billing inquiries. The position obtains and updates patient demographic and insurance information; explains and collects required identification, insurance cards, signatures, and regulatory forms; verifies coverage, benefits, authorizations, and referrals; and screens patients for potential funding sources. It establishes financial expectations, prepares procedure estimates, and coordinates with clinical areas and other providers to resolve revenue-cycle issues. The representative collects, posts, and reconciles patient payments, including providing receipts, communicating expected patient liabilities before service, and completing end-of-shift balancing forms. The role also performs other appropriate duties in a competent, professional, and courteous manner.

Requirements

Excellent customer service skills.
Ability to receive and communicate detailed information orally and in writing.
Ability to use appropriate negotiation techniques when collecting money owed by patients or guarantors.
Knowledge of insurance plans and benefits.
Computer literacy and ability to work in 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 and flexibility to work Friday, Saturday, and Sunday, including flexible and staggered shifts.
Ability to perform substantial walking.
Associate degree, or high school diploma with two years of customer service experience, as listed under essential education requirements.
High school diploma or GED with one year of customer service experience, as listed under additional job description.

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 demographic and insurance information for patients and guarantors in registration systems.
Secure or explain insurance cards, identification, signatures, and required forms; scan documentation into the appropriate imaging system.
Complete Medicare Secondary Payer questionnaires when applicable and discuss advance directives, privacy notices, and billing information with patients.
Verify insurance eligibility, coordination of benefits, and authorization or referral requirements using payer websites, real-time eligibility tools, or telephone contact.
Identify patients correctly, apply identification bracelets when applicable, and follow downtime registration procedures.
Provide service recovery for patients and visitors when needed.
Verify financial information and pre-certification or prior-authorization requirements.
Inform self-pay patients about prepayment requirements and screen patients for potential funding sources.
Prepare procedure estimates, calculate advance payment requirements, and explain acceptable payment arrangements for current and previous balances.
Refer potentially eligible patients to contract eligibility vendors and coordinate with clinical areas to establish financial expectations and resolve revenue-cycle issues.
Maintain current knowledge and skills and meet facility, unit, and payer performance metrics, including attending required training and reviewing communications.
Collect patient payments, issue receipts, and contact patients before service to explain expected financial liability and benefits and accept payment by phone when agreed.
Coordinate with providers when payment cannot be collected and obtain a waiver for services when necessary.
Post payments accurately and reconcile receipts with cash collected, completing required balancing forms at the end of the shift.
Perform other position-appropriate duties in a competent, professional, and courteous manner.