Patient Access Representative II - Pediatrics (Bay Area)

About the Role

The Patient Access Representative supports our Bay Area Primary and Specialty Pediatric Care clinic by delivering exceptional patient service and managing front-end clinic operations. This position handles patient registration, scheduling, insurance verification, and collections while ensuring accurate documentation and smooth daily workflows. Success requires strong communication skills, attention to detail, and the ability to navigate insurance benefits and managed care plans. The individual will work closely with patients and staff to maintain an efficient, patient-focused experience.

Responsibilities

• Obtains demographic, insurance, and financial information from patient or guarantor.
• Enters information in computer system with a high degree of accuracy.
• Schedules patient appointments and enters required information in the computer system accurately and timely.
• Explains all required forms to the patient or guarantor and obtains necessary signatures.
• Ensures medical necessity compliance by obtaining necessary data, reviewing Compliance System, communicating information to patient or guarantor, and obtaining necessary signatures.
• Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options, and screening for eligibility.
• Completes complex financial counseling including review and submission of charity applications.
• Identifies alternative resources for financial reimbursement.
• Verifies insurance eligibility and benefits; ensures all notifications and authorizations are completed within required timeframes.
• Posts payments in the computer system and generates appropriate patient receipts.
• Communicates effectively and professionally with physicians, care management, ancillary departments, nursing units, physicians' office staff, insurance companies, patients, and their families.
• Completes thorough and accurate documentation.
• Adheres to all university policies, procedures, and standards, including time management, supply management, productivity, and accuracy of practice.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency.
• Supports department-based goals contributing to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
• Performs other duties as assigned.

Requirements

• High School Diploma or equivalent required.
• 2 years of experience in a hospital or medical business office setting required.

Skills

• Strong communication skills.
• Attention to detail.
• Ability to navigate insurance benefits and managed care plans.

Benefits

• 100% paid medical premiums for full-time employees.
• Generous time off (holidays, preventative leave day, vacation, and sick time equating to around 37-38 days per year).
• Increased vacation accrual with longevity.
• Longevity Pay (monthly payments after two years of service).
• Retirement/pension plan.
• Free financial and legal counseling.
• Free mental health counseling services.
• Gym membership discounts and access to wellness programs.
• Employee discounts (entertainment, car rentals, cell phones, etc.).
• Resources for child and elder care.

Physical Requirements

Exerts up to 50 pounds of force occasionally and/or up to 20 pounds frequently and/or up to 10 pounds constantly to move objects.

This position is security-sensitive pursuant to Texas Education Code 51.215 and Texas Government Code 411.094. Employees must permanently reside and work in the State of Texas.