Patient Access Representative

Patient Access Representative (Healthcare) Responsibilities

• Oversees the process of incoming patient orders, verifies order validity, and adds the order information to the tracking spreadsheet.
• Obtains current, complete, and accurate demographics at pre‑registration and registration.
• Verifies insurance eligibility and collaborates with the pre‑service team to obtain prior authorization for walk‑in patients. Offers financial assistance as appropriate and provides the patient form to complete.
• Completes all necessary forms in association with securing payments.
• Complies with all payer regulations and requirements.
• Completes medical necessity review along with all applicable documentation for ABN or Notice of Non‑Coverage.
• Assists with patient scheduling as necessary.
• Serves as backup to the Patient Access Support functions (switchboard operator, mail processing).
• Identifies problems and offers constructive suggestions for improvement within the department with the Patient Access Manager in a private setting.
• Performs other duties and responsibilities as assigned.

• 1+ years of experience in customer service and/or clerical role preferred.