The posting
Position Location:
Hospital for Special Care
Scheduled Weekly Hours:
40
Work Shift:
First Shift
Department:
Outpatient Services
We are dedicated to creating an environment of care and engagement that makes us one of the most desirable places to work, providing exceptional care to each patient each and every day!
Patient Access Representative 6712
Position Summary
The Patient Access Representative serves as the first point of contact for patients, delivering exceptional customer service while coordinating access to outpatient hospital and physician office services.
This role is responsible for accurate patient registration, appointment scheduling, insurance verification, financial clearance, and other revenue cycle activities that support timely access to care.
Working in a fast-paced healthcare environment, the representative ensures accurate patient and insurance information, supports compliant billing and reimbursement processes, performs ongoing analysis of accounts to determine eligibility and benefits, and collaborates with patients, providers, clinical staff, and administrative departments to promote an efficient, positive patient experience while maintaining compliance with HIPAA, payer requirements, organizational policies, and applicable regulatory standards.
Essential Duties and Responsibilities
Qualifications
- Required: High School Diploma.
- Preferred: Associate degree.
- Preferred: Prior experience in healthcare registration, scheduling, patient access, or a related healthcare/customer service role.
- Required: Excellent communication, organizational and interpersonal skills.
- Required: Strong verbal and written communication, reading comprehension, and basic math skills.
- Required: Ability to exercise sound judgment, problem-solve, and resolve routine patient access concerns.
- Preferred: Proficiency with electronic health record systems, scheduling/registration systems, and Microsoft Office Suite.
- Preferred: Basic knowledge of medical terminology.
- Required: Keyboarding, computer use, multi-line phone, and data entry proficiency.
- Required: Excellent organizational skills with the ability to multitask, prioritize, and adapt to changing priorities.
- Required: Commitment to accuracy, confidentiality, HIPAA compliance, and exceptional customer service.
- Required: Professional demeanor with the ability to communicate effectively with patients, providers, and staff.
Physical Demands
- This position requires walking, standing, and sitting with the ability to lift/carry and push/pull up to 20 pounds frequently.
- This position also requires frequently looking at a computer and using a telephone for extended periods of time.
- This position requires the ability to bend, squat, balance, reach above shoulder height and twist frequently.
- The ability to touch, see, and hear are required continuously with gross grasp and fine manipulation.
Cognitive Demands
- Ability to make meaningful observations, evaluations, and reports.
- This position requires high levels of independent judgment, problem solving, written expression / communication, verbal expression / communication, reading / auditory comprehension and computation skills.
- Adjust schedule to adapt to changing priorities.
- Initiates and responds to work independently; accesses resources and can handle multiple responsibilities simultaneously.
Work Demands
- This position requires the ability to work under a variety of conditions that includes moderate noise and frequent interruptions.
- Demonstrates a positive, patient-centered attitude while maintaining professionalism during high-volume and stressful situations.
- Ability to deal effectively with stress.
- Follows infection prevention and safety protocols, including Universal Precautions when applicable.
- Accuracy and attention to detail with time sensitive awareness.
- Ability to work in team-oriented and independent environment.
- Ability to effectively train, mentor, and share knowledge with team members.
Patient Registration & Scheduling
- Performs assigned patient access, registration, and scheduling functions to support efficient outpatient operations.
- Greets and registers patients via phone, text, or in-person interactions in a courteous and professional manner. Accurately collects, updates, and maintains patient demographic, insurance, guarantor, and billing information within the Electronic Health Record (EHR). Provides patients with information regarding organizational policies, procedures, and available resources.
- Ensures accurate account selection, registration workflows, and patient information are completed prior to services being rendered.
- Completes pre-registration activities and reviews scheduled visits to confirm required patient and insurance information is available prior to appointments.
- Schedules, coordinates, and adjusts appointments as requested by patients, providers, and clinical teams, including follow-up appointments and scheduling changes requiring coordination across departments or external vendors.
- Prepares, distributes, and obtains required patient forms and signatures.
- Prints patient identification bracelets as necessary for hospital visits and procedures.
- Issues visitor badges to patients and accompanying family members according to organizational policy.
- Monitors clinic flow and scheduling efficiency and escalates operational issues as appropriate to support timely service delivery.
- Provides front office coverage and operational support based on department needs.
- May travel between clinic locations to provide operational coverage as required.
Insurance Verification, Eligibility & Financial Coordination
- Obtains, verifies, and updates insurance information, including primary, secondary, and tertiary coverage, payer order, and required documentation.
- Verifies insurance eligibility, benefits, coordination of benefits (COB), and payer-specific requirements through online portals, payer communication, and internal systems.
- Performs ongoing review and analysis of scheduled visits and patient accounts to determine continued eligibility of benefits, identify coverage changes, and ensure appropriate updates are completed to minimize delays, denials, or financial risk.
- Reviews patient accounts for accuracy and completeness, ensuring demographic, insurance, and financial information supports timely billing and reimbursement.
- Documents verification methods, account updates, and patient interactions accurately within the EHR.
- Maintains working knowledge of insurance coverage, benefits, Medicare Secondary Payer (MSP) questionnaires, Advanced Beneficiary Notices (ABNs), and Memorandums of Understanding (MOUs).
- Provides outpatient service estimates and communicates insurance benefits, patient responsibility, co-payments, deductibles, and financial obligations to patients.
- Collects co-payments, deductibles, and outstanding balances; processes payments and completes required end-of-day reconciliation according to organizational procedures.
- Identifies patients with coverage limitations and provides appropriate financial assistance resources.
- Ensures required authorizations and referrals are available when applicable and collaborates with authorization teams or other departments to resolve patient access barriers.
Administrative & Clerical Support
- Responds to incoming calls, emails, faxes, and other communications; routes inquiries to appropriate personnel as needed.
- Utilizes appropriate communication platforms and electronic systems to support patient access workflows.
- Maintains and scans patient documentation into the Electronic Health Record accurately and promptly.
- Manages patient check-in and check-out processes efficiently to support positive patient flow.
- Maintains waiting room organization and supports patient comfort during the check-in process.
- Maintains an organized, HIPAA-compliant workspace and participates in office opening and closing procedures.
- Cross-trains across registration and scheduling functions and provides coverage for other Patient Access areas as operational needs require.
- Assists with training new staff members and supports workflow coordination among team members.
- Maintains inventory of office supplies, forms, and patient materials as applicable.
Communication & Collaboration
- Communicates schedule changes, cancellations, reschedules, and no-shows to appropriate team members while ensuring accurate documentation and use of appropriate reason codes.
- Collaborates with Team Leads, Office Coordinators, Administrative Assistants, clinical staff, providers, and other departments to resolve patient access issues and support timely services.
- Promotes organizational programs and initiatives such as patient portal enrollment, financial assistance resources, and other patient engagement services.
- Communicates clearly, respectfully, and professionally with patients, families, providers, and staff while maintaining confidentiality and demonstrating cultural sensitivity.
- Handles patient complaints and concerns with empathy and professionalism and escalates issues to leadership when appropriate.
- Participates in department meetings, quality improvement initiatives, and continuing education opportunities.
- Maintains compliance with HIPAA, organizational policies, payer requirements, and regulatory standards while protecting patient confidentiality and ensuring accuracy of patient records.
- Performs other duties as assigned.
COMPENSATION & BENEFITS
At Hospital for Special Care, we are committed to supporting the health, financial well-being, and professional growth of our team members. The wage range for this position is $17.99 to $27.01. Eligible employees may participate in a comprehensive benefits package that includes employer-subsidized medical and dental, vision insurance; a 403(b) retirement savings plan with an employer match of up to 6%; paid time off; employer-paid life insurance; short-term and long-term disability insurance; a Health Savings Account (HSA) with employer contributions; Flexible Spending Accounts (FSA); an Employee Assistance Program (EAP); tuition reimbursement and professional development opportunities; voluntary benefits, including pet insurance; employee wellness programs with access to our onsite fitness and aquatics center; an employee referral bonus program; and meaningful employee recognition and appreciation initiatives. Eligibility for certain benefits is based on scheduled hours worked.
