Job Description
SUMMARY:
The Patient Access Representative I – Insurance Verification is responsible for verifying insurance eligibility, securing authorizations, and ensuring accurate patient registration to support timely and complete reimbursement. This role serves as a key liaison between patients, providers, and payors, ensuring a seamless financial clearance process prior to service delivery.
ESSENTIAL FUNCTIONS:
· Verify insurance eligibility and benefits using electronic tools and payer portals.
· Obtain prior authorizations and document approvals in the registration system.
· Collect co-pays, deductibles, and outstanding balances; establish payment plans when needed.
· Explain insurance coverage, financial responsibility, and available financial assistance to patients.
· Register patients accurately, ensuring all demographic and insurance data is complete.
· Coordinate with clinical departments and physician offices to confirm procedure details and scheduling needs.
· Respond to patient inquiries regarding insurance, billing, and scheduling.
· Maintain accurate documentation of all verification and authorization activities.
· Reconcile daily cash drawer and ensure compliance with financial policies.
· Adhere to HIPAA and organizational confidentiality standards.
· Performs related duties as assigned.
MINIMUM QUALIFICATIONS
EDUCATION:
EXPERIENCE: One (1) year of experience in a healthcare setting preferred, especially in insurance verification or scheduling.
LICENSURE OR CERTIFICATION: None required.
KNOWLEDGE, SKILLS, AND ABILITIES:
· Knowledge of insurance plans, medical terminology, and healthcare billing practices.
· Strong communication and customer service skills.
· Proficiency in EHR systems and payer verification tools.
· Ability to multitask in a fast-paced environment.
· Attention to detail and accuracy in data entry.
· Basic computer and office equipment proficiency.