Patient Access Rep 2 - Pulmonology Clinic

Employer paid benefits - Medical, Dental, and Vision

Hourly Rate:  Min:  $24.46  Max:  $37.75

A Patient Access Representative 2 manages front-office and patient coordination tasks to support smooth healthcare operations and timely patient care. Responsibilities typically include:

• Providing customer service by phone and in person
• Completing outpatient registration and pre-registering admissions
• Collecting payments and co-payments
• Verifying insurance coverage and benefits
• Filing and maintaining patient documentation and charts
• Taking accurate messages and ensuring timely delivery
• Communicating with insurance companies to verify or obtain authorizations and medical necessity approvals
• Coordinating with providers, medical assistants, front office staff, and billing/business office teams
• Managing prior authorizations and ensuring insurance requirements are met
• Overseeing referrals for specialty care, diagnostic testing, procedures, and medications to help patients access care promptly
• The role combines patient service, administrative coordination, insurance verification, and referral management to support efficient clinic or hospital operations.

Essential Job Functions:

• Collect patient demographic and insurance information then accurately keys this information into the electronic patient record systems completing outpatient registrations
• Correctly takes messages either by phone, ensuring all necessary information is gathered and documented following departmental guidelines. Also ensure that the messages are delivered in a timely manner.
• Coordinates all inbound and outbound referrals by reviewing provider orders, initiating referral requests, and ensuring necessary documentation (chart notes, imaging, labs, etc.) is submitted accurately to the receiving specialist or facility.
• Works closely with providers, nursing staff, front office, and the business office to support seamless care coordination.
• Must be flexible and available to work various shifts, including extended evening hours or weekends, based on clinical needs. Adjustments to hours or responsibilities may be required as workload or patient volume fluctuates.
• Scans in patient insurance benefit, patient liability estimate, and authorization information into electronic health record daily.
• Provides courteous and professional customer service via phone (within 3 rings), assisting patients and providers as needed.
• Collects Co-pay or Co-insurance to appropriate accounts
• Communicate with insurance companies to obtain or verify authorization of care
• Secures medical necessity checks/verification in accordance with Centers for Medicare & Medicaid services, verifies insurance benefits, coverage & eligibility, completes assigned registration work lists activities, obtains/verifies insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors.
• Thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of admissions, Important Message from Medicare, EMTALA, etc.). Scan Protected Health Information, create and file patient information packets/folders for Hospital services.     
• Assists with scheduling diagnostic procedures.
• The employee supports the hospital mission, vision, values, policies, and procedures.
• Participates in required education for DNV programs as applicable to position (reference program education curriculum).
• Performs other related duties as assigned.

Qualifications:

Education

                Required: High School Diploma or equivalent.

                Preferred: NA                                                                                                                                        

Licenses/ certifications/ registrations

Required: NA

                Preferred: NA

Experience

Required: NA

                Preferred: Minimum of 2 years hospital collection experience preferred.

Other:

• Bilingual and/or English Spanish speaking preferred. Ability to work with culturally diverse population.

Physical Requirements:

Prolonged periods of sitting at a desk and working on a computer. Occasional walking, standing, bending, or lifting light office items (up to 25 pounds). Visual acuity to view computer screens and read detailed financial documents. Ability to communicate effectively in person, by phone, and electronically. May be required to move throughout the healthcare facility, including administrative and clinical areas.

Working Conditions:

This position operates in a professional office setting within a healthcare facility. The role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets. The office environment is climate-controlled, well-lit, and ergonomically designed for extended computer work. While this role is primarily office-based and does not involve direct patient care, the employee may occasionally be present in clinical areas or interact with staff working in clinical environments. As such, there is a potential for exposure to infectious diseases. The organization provides appropriate training and personal protective equipment (PPE) as needed to ensure safety.