PATIENT ACCESS REPRESENTATIVE

About the role

The Patient Access Representative performs detailed and accurate registration of all patients, displays a broad understanding of third‑party reimbursement issues, and assists ancillary departments with room assignment and patient transport. The role works under the supervision of the Patient Access Supervisor or Administrative Director, Revenue Cycle.

Responsibilities

• Greets and interviews incoming patients or relatives to obtain accurate demographic and insurance information.
• Inputs patient demographic and billing information into the computer system.
• Obtains patient or responsible party’s signature on consents.
• Creates face sheets, armbands, labels, and other required documents.
• Communicates consent details, insurance filing, and payment information to patients.
• Assists patients in understanding hospital billing and collects payments.
• Collects and scans insurance cards or completed insurance forms from patients.
• Obtains necessary signatures on consent forms for treatment per hospital policies.
• Collects co‑payments and deposits or refers patients to Patient Accounting for standard payment arrangements.
• Interprets physician orders to incorporate up to nine service types and over 31 service locations, identifying qualifying requirements.
• Implements correct accommodation codes from physician orders to ensure accurate charges and billing.
• Updates patient status changes to reflect all physician/provider order entries.
• Uses the QAS Address Verification System to confirm address legitimacy with the U.S. Postal Service.
• Utilizes the Waystar Insurance Eligibility product to validate insurance coverage during registration.
• Initiates, audits, and supports Medicare Secondary Payer questionnaires for all Medicare registrations.
• Provides 24/7 answering service support to community physicians.
• Performs next‑day audits on all registrations, including ancillary areas, to ensure accuracy and reduce AR days.
• Distributes registration records daily to appropriate departments and referring physicians.
• Cross‑trains in at least two of the four Patient Access areas (Outpatient Registration, ER, PBX, Pre‑Admissions).
• Participates in on‑call obligations to maintain 24/7 coverage in the Emergency Room Patient Access area.
• Directs patients to appropriate ancillary departments.
• Coordinates with nursing supervisors or units to arrange proper bed assignments and patient transport.
• Performs receptionist duties: answering phones, paging, taking messages for doctors and nurses, and contacting physicians.
• Provides PBX coverage during breaks, lunches, after‑hours, and nightly (post 8:30 pm), handling calls, code notifications, payments, and information for patients and visitors.
• Operates printers, scanners, credit‑card terminals, and copy machines.
• Maintains confidentiality of personnel and patient information.
• Actively participates in strategic quality management for the department and organization.
• Engages in customer/guest relations and mandatory education programs.
• Complies with the hospital’s corporate compliance program, including the Code of Conduct, applicable laws, regulations, and policies.
• Must be free from governmental sanctions involving health‑care or financial practices.
• Other duties as assigned (non‑exhaustive).

Qualifications

• Education: High school diploma or GED equivalent (preferred).
• Experience: Prior medical office and/or hospital admitting experience, including billing (preferred).
• Required: Prior customer‑relations experience.
• Required: Proficiency with computer systems, keyboarding, and 10‑key calculator.
• Preferred: Knowledge of medical terminology.