Patient Access Representative

About the role

The Patient Access Representative plays a crucial role in providing exceptional customer service and supporting the operations of Harbor Community Health Center-Plymouth. This position is essential for maintaining a smooth front-end process, minimizing billing issues, and delivering an exceptional patient experience.

Responsibilities

• Patient Access & Registration
• Welcome and assist patients, families, and guests professionally and courteously.
• Accurately collect and enter demographic and insurance information.
• Schedule, reschedule, or cancel appointments as requested.
• Collect co-pays and process patient payments according to policy.
• Ensure completeness of PCP assignment and referral requirements.
• Submit applications for HSN Presumptive Determination and SFS discounts, as needed.
• Register walk-in and new patients and distribute new patient registration information.
• Refer patients to Financial Counselors for insurance enrollment or changes.
• Insurance Verification & Financial Navigation
• Verify insurance eligibility, coverage, and PCP/plan assignment using online portals or direct payer calls.
• Ensure prior authorizations are obtained as required in accordance with the site workflow.
• Review and correct patient's demographic and insurance information in EPIC to support timely, accurate billing.
• Contact patients in advance of appointments when insurance cannot be verified.
• Educate patients on payment options including Health Safety Net (HSN), Sliding Fee Scale (SFS), and self-pay.
• Coordinate with Financial Counselors to ensure patients have appropriate documentation and appointments.
• Calculate and communicate patient financial responsibility prior to service.
• Administrative and Operational Support
• Review next-day appointment schedules and monitor appointment flow.
• Answer and route telephone calls promptly and courteously.
• Perform related clerical tasks such as sorting mail, managing the bump list, and general front-desk support.
• Review patient encounters post-visit to ensure adherence to protocols and workflows.
• Maintain strict confidentiality and a high level of professionalism in all interactions.

Requirements

• High school diploma or GED
• 1+ years of experience in a community health center and/or a professional/business environment, 3+ years of healthcare-related experience preferred
• Excellent verbal and written communications skills
• Excellent customer service skills
• Excellent organizational, problem-solving, and priority-setting skills
• Basic computer literacy, knowledge of Microsoft Office 365 preferred including Word, Excel, Outlook, and Teams
• Knowledge of Electronic Practice Management (EPM) and/or Electronic Medical Record (EMR) preferred, EPIC/OCHIN desired
• Basic math and reading comprehension skills
• Bilingual: English/Portuguese or English/Spanish preferred
• Familiarity with using medical terminology preferred
• Medical and/or Dental Billing experience preferred