Patient Access Representative - Pediatric Multi-Specialty - Children's Pavilion - Days

The Patient Access Representative delivers high-quality customer service to patients of all ages, their families, visitors, medical staff, clinicians and co-workers, ensuring all interactions are courteous, timely and respectful.

The Patient Access Representative handles all business functions in an assigned clinical department area to include reception, scheduling, and registering patients for appointments and/or procedures. This position also secures the appropriate patient information; ensures that registration data is correct and accurate; validates insurance eligibility, ensuring accurate data entry; collects co-pays, and supports financial counseling and financial clearance, as necessary.

Essential Job Statements

Greet Patients/Answer Telephone 
Provides exceptional customer service by welcoming patients and visitors in a friendly, professional, and respectful manner.  Ensures individuals are respected and informed, communicating clearly and effectively, and utilizing appropriate language resources as needed.  Assists with traffic flow in and out of the clinic as needed.  Addresses patient needs promptly, and maintains a courteous, professional tone at all times.   

 

Co-payment Collection & Registration Data 
Collects all patient co-payments and deposits accurately per payer, following department guidelines.  Verifies and updates registration data, including demographic and insurance information. Copies and records insurance information per department standards. Follows department policies for cash handling, including cash reconciliation and deposit preparation.    

 

Referral Management  

Verifies insurance coverage and understands requirements for HMO, managed care, government and private plans. Secures required referrals/authorizations and links them correctly in the referral module. Obtains needed referrals and authorizations before scheduled procedures, tests, injections and surgeries. Communicates plan-specific referral/authorization requirements to patients and providers.  Provides pre-payment guidance for self-pay patients and offers financial assistance. Prepares cost estimates, explains payment expectations and documents all interactions in the patient account.    

 

Appointment Scheduling, Lab & Test Order Entry 
Correctly schedules clinic appointments through the medical records software/communication platform. Transcribes physician orders accurately and completely (i.e. lab test, ancillary test