Patient Access Representative Job Description

Patient Access Representative Job Description

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Patient access representative provides guidance and direction to various departments regarding current insurance regulations and payment policies.

Patient Access Representative Duties & Responsibilities

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

Sample responsibilities for this position include:

Reviews and processes patient registration forms and ensuring they contain all necessary documents
Assists in training new employees for the admitting responsibilities
Addresses questions and requests regarding financial assistance
Responsible for communicating with patients regarding patient financial responsibilities before or at time of service
Coordinates and supports activities to ensure excellence in throughput for inpatient and observation patients
Responsible for review and ensure correct coding of patient types, medical services to support billing and revenue cycle goals to include patient status changes
Follow appropriate patient placement utilizing the facilities bed allocation
Completes and files death certificates with Brookhaven Town and Department of Health
Determines eligibility and patient cost share (co-pay / deposit ) using electronic systems and other means, taking payments at point of service
Determines and communicates to each patient/patient representative, confirming how the encounter will be paid, and properly assist in screening self-pay patients to determine Medicaid or Charity Care options, referring to a Financial Counselor when appropriate

Patient Access Representative Qualifications

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

Licensing or Certifications for Patient Access Representative

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

Education for Patient Access Representative

Typically a job would require a certain level of education.

Employers hiring for the patient access representative job most commonly would prefer for their future employee to have a relevant degree such as Associate and High School Degree in Associates, Education, Technical, Computer, High School Education, Communication, Healthcare, Business, Medical, Computing

Skills for Patient Access Representative

Desired skills for patient access representative include:

Medical terminology
Commercial and government insurance plans
Government resources
Payer networks
Current insurance regulations and policies
Policies and procedures pertaining to registration
Order entry
Computer systems
Insurance/government regulations and UH/PAS policies/procedures used within the department
Microsoft Office

Desired experience for patient access representative includes:

1 year experience in Patient Access, Patient Financial Services, or previous experience in a hospital or physician’s office required
Supervisory and/or leadership experience preferred
Ensures that compliance regulations are met (including ensuring securing consents and regulatory signatures from patients or designee, essential for treatment and payment, as per procedure)
Maintains and requires appropriate documents as necessary
Provides financial guidance and excellence in Financial Care to patients and their representatives including information about their health care insurance coverage, cost share responsibilities and for self-pay patients, qualification for Medicaid and / or the financial assistance working to ensure complete applications for Medicaid and/or Financial Aid applications
Assists and instructs staff clients on issues related to insurance verification of authorizations and referrals

Patient Access Representative Examples

1

Patient Access Representative Job Description

Job Description Example
Our growing company is hiring for a patient access representative. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for patient access representative
  • Monitors staff productivity and provide constructive feedback to staff with management guidance
  • Train and in-service new and continuing employees on a continuing basis
  • Obtain insurance eligibility verification for all patients
  • Provide routine and complex financial counseling to patients, researches routine and complex billing issues
  • Work collaboratively with the back office teams to ensure an exceptional patient experience
  • This position may require working in various areas throughout the patient access department
  • This position may require that you work in the hospital and / or off site areas
  • The Patient Access Representative serves as the first point of contact for visitors who enter the facilities and is responsible for all aspects of customer service for Patient Access/Patient Accounts areas in a manner that ensures a customer focused, quality conscious work climate
  • Primary functions include, focusing on interpersonal skills, data collection, and the ability to assess situations and to assist the team in developing solutions to achieve excellence in customer service while ensuring the financial viability of the hospital
  • Collecting and verifying patient and insurance demographics, securing pre-certifications and/or pre-notifications for patient services, collection of co-pay and deposits prior to services and providing financial assistance to patient
Qualifications for patient access representative
  • Ensures that all patients are received in a timely manner
  • Collects patient information including, demographic, insurance, emergency contact and physician information
  • Verifies patient’s co-payments and deductible responsibilities and ensures collection
  • Coordinates timely bed placement for all inpatient, transfers and outpatient bed requests
  • Assigns beds / unit according to the medical needs of the patient, census count and type of accommodations available
  • Demonstrated ability to perform simple math calculations
2

Patient Access Representative Job Description

Job Description Example
Our company is hiring for a patient access representative. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient access representative
  • Provides explanation of visit, instructions, and addresses concerns and questions
  • Register patients for medical care
  • Collect and confirm complete patient demographics, including current employer, emergency contact information, insurance and case-specific information
  • Schedule appointments and assign appropriate length of visit per provider request
  • Provide excellent customer service through prompt and thoughtful assistance to patients and families
  • Understands scope of practice of each physician within the ophthalmology department
  • Maintains knowledge of ocular anatomy and ophthalmic disease processes which would result in patients being scheduled with the correct ophthalmic sub-specialist based on the patient's complaint, disease, systemic illness
  • Correctly schedules procedures, diagnostics testing, and appointments within the eye clinic, appropriately scheduling tests and physicians' appointments in appropriate order based on need for dilation or corneal manipulation
  • Triages ophthalmology appointment calls correctly determining what sub-specialist the patient needs to see and the appropriate time frame for the patient to be seen based on his/her complaint
  • Performs patient registration functions
Qualifications for patient access representative
  • Knowledgeable and experienced with various computers systems
  • Meets with patient and/or patient's caregiver to exchange necessary information and documentation
  • Communicates with referring provider's office, clinical department(s), and/or other appropriate personnel to exchange necessary information and determine schedule
  • One year of experience working with healthcare registration, insurance and/or collection
  • Computer knowledge, 35 wpm typing speed preferred
  • Creates a customer service-oriented atmosphere by providing information, updates, and options to meet the patient needs
3

Patient Access Representative Job Description

Job Description Example
Our company is hiring for a patient access representative. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient access representative
  • Perform clerical and administrative duties as assigned
  • Greet patients and visitors, providing check-in and check-out functions
  • Answer phones and schedule appointments, ensuring patient is seen in a timely manner
  • Coordinate insurance authorizations
  • Appropriately distribute/triage phone calls to other areas and/or clinical providers (billing, nurse, operations lead)
  • Accurately access patient medical records
  • Input physicians orders appropriately to patients records
  • Review documentation for ongoing patient care
  • Communicate patient record with ancillary hospital services
  • Maintains patient confidentiality as outlined by privacy and HIPAA guidelines
Qualifications for patient access representative
  • Hospital or physician office-helpful
  • Insurance knowledge-helpful
  • BLS certification required within 6 months of hire
  • Current BLS for the Healthcare Provider is required
  • Minimum of a High School diploma or equivalent education
  • Positive attitude and cooperative toward his/her position, the hospital and fellow employees
4

Patient Access Representative Job Description

Job Description Example
Our company is growing rapidly and is looking to fill the role of patient access representative. 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 representative
  • Cross trains in other areas of Patient Access and is able to provide adequate coverage based on department needs
  • Resolves Physicians office and Patient issues
  • Obtains demographic and financial information
  • During the pre-service visit, obtains signatures, demographic information, emergency contact information and other pertinent information not previously obtained
  • Assess patients financial resources, including identification of possible eligibility for public benefits, those in need of financial assistance or those capable of making payment at time of service
  • Responsible for scanning patients insurance card and identification at time of service
  • Responsible for identification of co pay and deductibles, communicating patient financial responsibility at point of service and collection of such patient responsibility at point of service
  • Communicates to Physician Office to obtain accurate and complete orders for services at St James Healthcare
  • Coordinates self pay patient flow to appropriate Patient Access or HCFS staff
  • Will screen for and process non-covered service and waiver of liability (ABN) through automated screening at time of service
Qualifications for patient access representative
  • Medical office Experience a must, Medical Billing and Coding experience a plus
  • Front office staff is responsible for greeting and registering patients and visitors
  • Capture demographic information from the patient, registration, preregistration and general customer service
  • Confirm accurate insurance information and confirms benefits eligibility
  • The scheduler or access coordinator is responsible for maximizing the schedule for the practice or healthcare system while simultaneously satisfying as many patients as possible by honoring requests for timely
  • Schedulers rely on electronic systems for scheduling, which can be complex and require computer skills
5

Patient Access Representative Job Description

Job Description Example
Our company is looking to fill the role of patient access representative. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient access representative
  • Answers phones and schedules appointments, Provides explanation of visit, instructions, and addresses concerns and questions
  • Performs departmental administrative functions as required
  • Process daily electronic insurance eligiblity verification
  • Review all insurance verification for eligibility/verification and consult with the appropriate areas for clarification or assistance
  • Update patient insurance registration as needed
  • Process routine and complex referrals
  • Answer referral line and assist patients answer queries in a timely manner
  • The Patient Access Representative will be responsible for answering phone calls in a patient-focused manner
  • Responsible for obtaining the necessary authorization prior to medical procedures
  • Medical Biller is responsible for follow up on insurance claim status, resolve denials/rejections, submit re-bills, re-submit claims, and file appeals
Qualifications for patient access representative
  • Ability to Diffuse Emotional Situations The successful candidate must be able to effectively handle difficult people and tough conversations without adding 'fuel to the fire'
  • Schedules of more than one clinician per visit
  • Knowledge of function and relationships within a hospital environment preferred Customer service skills and experience
  • This position requires technical accuracy, excellent communication skills and the highest ethical standards
  • Previous administrative experience in medical facility, health insurance, or related area preferred
  • 1-2 years clerical experience required, some college preferred

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