Patient Access Rep Job Description

Patient Access Rep Job Description

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Patient access rep provides assistance and direction to Managed Markets Sales to gain addition of promoted products to individual Commercial, Medicare and Medicaid formularies.

Patient Access Rep Duties & Responsibilities

To write an effective patient access rep job description, begin by listing detailed duties, responsibilities and expectations. We have included patient access rep job description templates that you can modify and use.

Sample responsibilities for this position include:

Answer back-line telephone calls, re-direct calls as appropriate, assist callers with questions or concerns and take messages as needed
Must meet 97% QC accuracy
Demonstrate knowledge of insurance and managed care requirements
Maintains & troubleshoot problems that arise with computers, printers, scanners, label printers and Welcome Kiosks
Registers incoming new/established patients by verifying or entering current demographic/insurance information into the computer system
Verifies patient appointment time, physician they are scheduled to see and insurance to be billed
Work Charge work queues
Verifies insurance coverage and obtains authorization for all services requiring pre-certification
Determines upfront payment or deposit based on the patient’s third party coverage and requests following department scripting for POS collections
Maintains an awareness of patient level of comfort during wait

Patient Access Rep Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Patient Access Rep

List any licenses or certifications required by the position: GOLD, CHAA, BLS, II, PAR

Education for Patient Access Rep

Typically a job would require a certain level of education.

Employers hiring for the patient access rep job most commonly would prefer for their future employee to have a relevant degree such as Associate and High School Degree in Associates, Business/Administration, Finance, Accounting, Healthcare Administration, Computer, Technical, High School Education, Healthcare, Medical Terminology

Skills for Patient Access Rep

Desired skills for patient access rep include:

HCPCS
ICD-10
CPT
Medical terminology
Medicare
Medicaid
Commercial payers
Departmental applications Eclipse
E-Cashiering
Enterprise Encounter

Desired experience for patient access rep includes:

IHS diploma or equivalent
Prefers 2~3 years related experience in a healthcare setting (revenue cycle experience preferred) hospital, physician office or insurance company
Must be able make change and count a cash drawer
Ability to work in a fast~paced environment with established time constraints and emotional and sensitive situations
Employee is regularly required to sit, stand, walk, talk and hear
Must possess visual acuity and manual dexterity to perform computer data entry and other clerical aspects of the job

Patient Access Rep Examples

1

Patient Access Rep Job Description

Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of patient access rep. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for patient access rep
  • Point of Service Collections – Collection efforts should be made and results documented into the patient's account
  • Service Excellence – Customer service efforts should exceed guest expectations while maintaining attention to detail
  • Communication – Communicates in a professional manner at all times with patients, visitors, co-workers, medical staff and ancillary departments
  • Teamwork-Acts as a team member
  • Maintain a professional relationship with the patient while providing excellent customer service and performing assigned duties
  • Properly and accurately registers patients utilizing legal name and date of birth and immediately issues patient identification bracelet at the end of the registration process
  • Completes quick reg process as required
  • Properly selects patients from the pre-registration status to complete the full registration
  • Registers patients using correct location
  • Answers the phone utilizing Departmental Scripting
Qualifications for patient access rep
  • May lift files, reference books, supplies, and other documents up to 10 lbs
  • May walk and push a wheeled cart with a computer and supplies weighing up to 50 lbs
  • This is both a sedentary and active position
  • May be exposed to a variety of illness and medical conditions
  • Must be able and willing to work weekends, holidays and occasionally other shifts
  • Must be able and willing to rotate work environments, ED, OP/ADM, Rover, Check~In, Phone Desk
2

Patient Access Rep Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of patient access rep. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for patient access rep
  • Directs patients to the appropriate testing area
  • Directs patient to registrar’s office for registration
  • Ensures that the Outpatient Greeters desk is manned during defined hours of service
  • Ensures that the Outpatient Greeters desk is clean and neat and contains no protected health information that is accessible or visible to others
  • Gathers necessary demographic, insurance and clinical information from patient and enters into appropriate database
  • Enter insurance policy number, group number, address, and telephone numbers
  • Verbally interview patient and/or family in order to obtain registration information
  • Identify co-payment procedures and fiscal procedures related to registration procedures
  • Complete computer and telephone pre-registrations to maintain patient flow
  • Schedule elective cases in applicable scheduling system accurately and completely per established process flows and standard operation procedures to support operations scheduling needs
Qualifications for patient access rep
  • Exhibit courtesy/respect for co-workers
  • May bend, stoop, twist and reach in conjunction with the job requirements
  • May need to work shifts at off~site locations
  • Computer literate and very strong with Excel, Word and Outlook
  • Ability to multitask and prioritization skills preferred
  • Healthcare environment experience is preferred
3

Patient Access Rep Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of patient access rep. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for patient access rep
  • Ensure CPTs are accurate for scheduled service, correct case status, validate and obtain proper precertification and referral is in place to ensure reimbursement
  • Ensures coordination of benefits with multiple insurance payors
  • Contacts physicians, their office staff and patient to obtain necessary information to complete pre-certification process
  • Provides patients, physician offices, facility departments, and patient access campus registrars with explanation of insurance benefits, limitations and authorization guidelines
  • Correctly identifies, collects and processes co-pays, deductibles, co-insurance and deposits from patients and may facilitate resolution of billing issues by liaising with patient accounting, patient, and insurance representative with the ability to provide payment arrangements
  • Understands and follows all patient access compliance and regulatory requirements for State, Federal which includes CMS
  • Special projects and duties as determined by manager / supervisor to support the goals and objectives of the department
  • At least 1 year experience in customer service or heath care required
  • Ability to type 25WPM, preferred, Basic computer skills required
  • Ability to utilize written and computerized resource materials
Qualifications for patient access rep
  • Knowledge of Patient Access process, Clinical Care process and Revenue Cycle
  • Ability to cope with the stress of the position and deadlines imposed
  • Professional manner and appearance in accordance to the Aultman Hospital policies
  • Knowledge of computer and the software systems utilized by the clinical, registration and patient financial services departments
  • To perform this job successfully, applicants should have computer skills and the ability to type 35 wpm
  • Must have clerical skills and exhibit technical knowledge of healthcare insurance benefits, various payor guidelines on referral and authorization processes have current knowledge of Federal, State and Local billing regulations
4

Patient Access Rep Job Description

Job Description Example
Our company is looking for a patient access rep. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient access rep
  • Ability to maintain documented productivity and quality standards for patient registration.Ability to have conversations regarding collection of copays and coinsurance and to successfully collect at point of service on a regular basis
  • Able to sit in one area for an extended period of time
  • Able to stoop, squat, kneel and utilize manual dexterity continuously
  • Must be able to use a keyboard and video display terminal to enter, receive, retrieve, transform words or data and/or audit information and data continuously
  • Must have normal or corrected vision in order to read the necessary materials and charts, including physician's orders for outpatient tests
  • Reviews and ensures that all medical orders are compliant and meet government and hospital guidelines clinical protocols
  • Performs other duties assigned by department supervisor or manager
  • Utilizes inputs to authenticate and register patients for service delivery for patients who have registered through the Patient Access Center
  • Performs revenue cycle tasks necessary to ensure compliance and exceptional customer service
  • Authenticates patient identity throughout all processes
Qualifications for patient access rep
  • Customer service experience in healthcare is preferred
  • 1 year of experience in either Patient Access or any of the following related experience general physician office support or billing office, insurance office, hospitality, or call center (any industry)
  • Minimum Experience Requirement
  • 1 plus year of experience in a Patient Access/Patient Accounting role
  • Patient Access – General Consent Orientation and Patient Financial Experience Training if assigned to Patient Access ED, Patient Access Urgent Care, Patient Access Specialty, Business Services JSCA, Main Admissions & Auths., and Patient Access Women’s Health (must be completed 30 days subsequent to hire)
  • Certified Healthcare Access Associate (CHAA)
5

Patient Access Rep Job Description

Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of patient access rep. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for patient access rep
  • Critical to this position is an understanding of the corporate revenue cycle and the importance of evaluating and securing all appropriate financial resources for patients to maximize reimbursement to the Hospital
  • Reporting to the Manager/Supervisor, this position is responsible for completing the inpatient and outpatient registration and insurance eligibility processes with Patient Access Services and creating the first impression of the Hospital's services to patients, family members and other external customers
  • The PAS Representative works directly with medical staff, nursing, ancillary departments, insurance carriers and other external professionals to assist families in obtaining health care and financial services
  • Obtains and accurately inputs all required data elements for scheduling and registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the encounter
  • Data fields include but are not limited to address, employment, insurance info, nearest relative, guarantor, insurance plan, admitting diagnosis, and physician information
  • Prioritizes and completes registrations / scheduling in a consistent, courteous, professional, accurate and timely manner
  • Selects appropriate patient type based on the department and services required
  • Arranges for the efficient and orderly admission of inpatients and admission of individuals who have hospital based outpatient testing or procedures
  • Ensures that the patient information is accurately collected and that patients are aware of hospital policies and procedures
  • Interviews incoming patient or representatives and enters information required for admission into computer database
Qualifications for patient access rep
  • Basic computer skills including proficiencies in Microsoft Windows, Excel, and Outlook, the ability to type 25 words per minute
  • Minimum one year experience in healthcare access, customer service and/or financial setting
  • Excellent typing/keyboarding skills with a high degree of accuracy in inputting data
  • Ability to complete detailed oriented work
  • Must possess a positive attitude and work well as part of a team independently
  • Minimum one year experience in healthcare access, customer service, office and/or financial setting

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