Patient Access Representative - Cottonwood, Camp Verde, Sedona, or VOC, AZ

Overview

The Patient Access Representative is responsible for verifying and collecting patient demographic and insurance information through direct data entry into the electronic medical record during scheduling, pre-admission, or admission processes prior to discharge. They conduct interviews with patients or authorized representatives to gather information related to requested services, accurately documenting discussions and registration activities in the encounter.

Responsibilities

Patient Registration and Scheduling

• Navigate web-based systems for registration or scheduling.
• Identify patients accurately for data entry of clinical, demographic, and insurance information during registration or appointment booking.
• Explain scheduled procedures and provide patient instructions necessary for diagnostic services.
• Ensure accurate documentation of activities related to patient contact, order entry, insurance verification, financial education, and payments.
• Explain legal forms and secure signatures from patients or authorized parties as required.
• Understand compliance standards, including EMTALA and HIPAA Privacy regulations.

Insurance Verification

• Identify and select insurance carriers in the medical record for specified dates of service.
• Use web-based systems to verify insurance eligibility, benefits, and authorizations.
• Notify and document insurance authorizations for services, procedures, and stays.
• Possess basic knowledge of CPT and ICD-10 coding as required.

Financial Counseling

• Understand insurance requirements for Medicare, Medicaid, Workers Compensation, and other payers.
• Educate patients on insurance coverage and financial assistance programs.
• Collect patient liabilities, process payments, and reconcile deposits.

Revenue Cycle Support

• Answer and route calls via PBX switchboard, including paging and emergency alerts.
• Support clinical departments with registration and insurance-related inquiries.

Compliance and Safety

• Report safety incidents promptly and participate in safety training.
• Adhere to federal and state regulations, including OSHA, HIPAA, and other policies.
• Maintain valid certifications and licenses as required.
• Complete mandatory training within designated timeframes.

Qualifications

• Education: High School Diploma or GED required; coursework in Medical Terminology preferred.
• Experience: At least 1 year in a customer service role required; 2 years in a medical or related field preferred.
• Proficiency in Microsoft Office applications is preferred.
• Must be able to physically attend work as required.

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