Patient Access Representative II

Overview

Employer paid benefits include Medical, Dental, and Vision. Wage compensation ranges from $24.46 per hour to $37.75 per year.

Definition Of Position

A Patient Access Representative 2 manages front-office and patient coordination tasks to support smooth healthcare operations and timely patient care.

Responsibilities

• Provides customer service by phone and in person
• Completes outpatient registration and pre-registering admissions
• Collects payments and co-payments
• Verifies insurance coverage and benefits
• Fills and maintains patient documentation and charts
• Takes accurate messages and ensures timely delivery
• Communicates with insurance companies to verify or obtain authorizations and medical necessity approvals
• Covers prior authorizations and ensures insurance requirements are met
• Coordinates with providers, medical assistants, front office staff, and billing/business office teams
• Manages referrals for specialty care, diagnostic testing, procedures, and medications to help patients access care promptly
• Combines patient service, administrative coordination, insurance verification, and referral management to support efficient clinic or hospital operations
• Collects patient demographic and insurance information then accurately keys this information into the electronic patient record systems completing outpatient registrations
• Correctly takes messages either by phone, ensuring all necessary information is gathered and documented following departmental guidelines. Also ensure that the messages are delivered in a timely manner
• Coordinates all inbound and outbound referrals by reviewing provider orders, initiating referral requests, and ensuring necessary documentation (chart notes, imaging, labs, etc.) is submitted accurately to the receiving specialist or facility
• Works closely with providers, nursing staff, front office, and the business office to support seamless care coordination
• Maintains flexibility and availability to work various shifts, including extended evening hours or weekends, based on clinical needs
• Scans in patient insurance benefit, patient liability estimate, and authorization information into electronic health record daily
• Provides courteous and professional customer service via phone (within 3 rings), assisting patients and providers as needed
• Collects Co-pay or Co-insurance to appropriate accounts
• Communicate with insurance companies to obtain or verify authorization of care
• Secures medical necessity checks/verification in accordance with Centers for Medicare & Medicaid services, verifies insurance benefits, coverage & eligibility, completes assigned registration work lists activities, obtains/verifies insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors
• Thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of admissions, Important Message from Medicare, EMTALA, etc.)
• Scan Protected Health Information, create and file patient information packets/folders for Hospital services
• Aids with scheduling diagnostic procedures
• Supports the hospital mission, vision, values, policies, and procedures
• Participates in required education for DNV programs as applicable to position (reference program education curriculum)
• Performs other related duties as assigned

Qualifications

• Education Required: High School Diploma or equivalent
• Experience Required: Minimum of 2 years hospital collection experience preferred
• Other: Bilingual and/or English Spanish speaking preferred. Ability to work with culturally diverse population

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer
• Occasional walking, standing, bending, or lifting light office items (up to 25 pounds)
• Visual acuity to view computer screens and read detailed financial documents
• Ability to communicate effectively in person, by phone, and electronically
• May be required to move throughout the healthcare facility, including administrative and clinical areas

Working Conditions

This position operates in a professional office setting within a healthcare facility. The role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets. The office environment is climate-controlled, well-lit, and ergonomically designed for extended computer work. While this role is primarily office-based and does not involve direct patient care, the employee may occasionally be present in clinical areas or interact with staff working in clinical environments. As such, there is a potential for exposure to infectious diseases. The organization provides appropriate training and personal protective equipment (PPE) as needed to ensure safety.