Patient Access Services Representative - TMCOne Copperstate OB/GYN

Tucson Medical Center • Tucson, AZ

311d

About The Position

The Patient Access Services Representative at TMCOne Copperstate OB/GYN assists medical caregivers with patient management, tracking, and monitoring requirements. This role involves answering phones, pre-screening calls using appropriate triage skills, handling prescription refills, communicating test results to patients, and scheduling appointments. The representative performs extensive centralized scheduling, insurance verification, referral, billing, and payment posting responsibilities.

Requirements

• High School diploma or General Education Degree (GED).
• Completion of vocational medical office training desired, or an equivalent combination of relevant education and experience.
• Preferred one (1) year of medical office and/or hospital experience, including healthcare eligibility and benefit analysis or scheduling experience.

Nice To Haves

• Certification as a Medical Assistant (CMA) may be required for some positions.
• Knowledge of office management practices, including billing and scheduling within healthcare.
• Knowledge of patient care protocols and practices.

Responsibilities

• Exhibits excellence in customer service through appropriate attitude and interaction with all patients, visitors, and staff.
• Collects deposits or deductibles and advises patients or guarantors of insurance benefits and anticipated cost estimates.
• Ensures completion of financial documentation in accordance with TMCH's credit and collection policies.
• Explains all necessary compliance forms and obtains patient signatures as required for regulatory agencies.
• Performs medical necessity screening and ensures compliance with system requirements.
• Interacts with physicians and/or their office staff to secure diagnosis, procedure details, or authorizations.
• Uses medical terminology and scheduling knowledge to select correct procedures when scheduling.
• Performs patient registration activities to ensure accurate financial and biographical data.
• Completes insurance processing, including account creation, insurance verification, and follow-ups on denials.
• Communicates with departments/physicians for special requests, emergent cases, and overbooking.
• Handles incoming telephone calls and exercises judgment in scheduling callers for the correct procedure.
• Explains procedure preparations to patients to ensure they are properly prepared before arriving.
• Documents all notification, authorization, and eligibility information in the registration systems.
• Analyzes patient accounts, determines non-collectable accounts, and recommends write-offs when applicable.
• Arranges payment methods or extensions of credit with patients or representatives.
• Maintains current working knowledge of payer regulations, contractual agreements, and collection tools.
• Provides information about external financial assistance, including recommending third parties.
• May serve as a Medical Assistant if holding a Medical Assistant Certification.
• Processes Accounts Payable transactions and verifies account balances.
• Adheres to TMCH organizational and department-specific safety, confidentiality, values policies, and standards.

What This Job Offers

• Job Type: Full-time
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED