Patient Access Representative I

JOB SUMMARY

The Patient Access Representative I will be responsible for accurately and efficiently obtaining and documenting all referrals and authorizations for physician clinic visits by contacting physician’s offices, insurance companies and/or patients. They are also responsible for scheduling patients for physicians according to patient need and physician protocol in a call center environment. Must obtain all information related to the appointment to include patient demographics, verifying, and documenting all new and existing insurance benefits to start the benefit and authorization process as well as method of referral. Answer the phone and handle each call appropriately, including making patient appointments. Friendly professionalism on the phone is crucial; you are the window into our practice, making the patient's first impression of our practice.

RESPONSIBILITIES:

• Coordinate with appropriate primary care physicians and/or insurance companies to obtain referrals for office visits prior to the patient’s scheduled appointment.
• Ensure all authorizations are properly documented in the system.
• Advise patients of any potential problems concerning obtaining authorization prior to the scheduled appointment.
• Utilize insurance websites (Availity, Humana Military (Tricare), United Healthcare, etc.) to obtain referrals/authorizations.
• Assure compliance with all company plans policies and procedures
• Receive and appropriately manage all calls coming into the practice
• Have a working knowledge of major insurance payors and accepted insurance plans
• Monitor accounts for bad debt and accounting issues, referring callers to the Billing department
• Efficiency in handling calls also extremely important, to handle a large volume of calls
• All other duties as assigned.

EDUCATION & EXPERIENCE

• Candidate must be a high school graduate.
• 2 or more years of experience in a Healthcare environment with registration/scheduling benefit/authorization background preferred.
• Must be detailed oriented.
• Excellent customer service and communication skills.
• Able to multi-task and handle high call volumes.
• Must have a working knowledge of Windows based computer environment and typing skills.
• Strong phone and customer service skills

PREFFERRED QUALIFICATIONS & SKILLS

• Possess knowledge and working understanding of scheduling system
• Experience in a medical center, large health system, or multi‑specialty group