Patient Access Representative

Overview

The Patient Access Representative (PAR) serves as the first point of contact for patients and plays a vital role in delivering exceptional customer service within a team-based, integrated healthcare environment. The PAR supports patient access for Medical, Dental, and Behavioral Health services by scheduling appointments, registering patients, verifying insurance eligibility and benefits, obtaining referrals and prior authorizations, collecting payments, maintaining accurate patient records, and facilitating communication between patients, providers, and care teams.

The Patient Access Representative is responsible for ensuring patients receive timely access to care while maintaining compliance with organizational policies, payer requirements, and patient-centered medical and dental home standards. This position requires excellent communication, organizational skills, attention to detail, and the ability to manage multiple priorities in a fast-paced clinical setting.

Minimum Skills, Experience, and Educational Requirements

High School Diploma or equivalent preferred.

• Minimum of one (1) year of experience in a medical, dental, behavioral health, or multi-specialty healthcare office preferred.
• Experience with electronic health records (EHR) systems preferred.
• Knowledge of medical, dental, and behavioral health insurance plans, eligibility verification, referrals, and prior authorization processes preferred.
• Excellent customer service and interpersonal communication skills.
• Strong organizational skills with the ability to prioritize multiple tasks and meet deadlines.
• Proficiency with Microsoft Office and standard office equipment.
• Ability to maintain confidentiality and comply with HIPAA regulations.
• Reliable attendance and punctuality.
• Bilingual English/Brazilian Portuguese preferred.

Responsibilities

Patient Registration and Customer Service

• Greet patients, families, and visitors in a courteous, professional, and respectful manner.
• Register and check patients in and out for Medical, Dental, and Behavioral Health appointments.
• Verify and update patient demographic information, including address, telephone number, email address, emergency contacts, and preferred language.
• Verify insurance coverage and primary care provider selection at each patient encounter.
• Collect required forms, obtain signatures, and ensure all registration documentation is complete.
• Collect copayments, outstanding balances, and other patient payments while issuing receipts and maintaining accurate payment records.
• Provide patient education materials, new patient packets, portal enrollment assistance, and visit summaries as appropriate.
• Maintain a welcoming, organized, and professional reception area.

Appointment Scheduling

• Schedule, reschedule, cancel, and confirm appointments for Medical, Dental, Behavioral Health, and ancillary services using the electronic health record.
• Coordinate appointments across multiple departments whenever possible to improve patient convenience and continuity of care.
• Schedule annual wellness visits, preventive visits, physicals, dental hygiene appointments, behavioral health follow-up visits, chronic disease management visits, and other recommended services.
• Manage provider schedules while following established scheduling protocols.
• Contact patients regarding appointment reminders, recalls, wait lists, and cancellations.
• Follow organizational procedures for missed appointments and no-show follow-up.
• Assist patients in establishing care with newly assigned providers.

Insurance Verification and Prior Authorizations

• Verify insurance eligibility and benefits for Medical, Dental, and Behavioral Health services prior to appointments whenever possible.
• Identify patient financial responsibility, including copayments, deductibles, coinsurance, and non-covered services.
• Initiate, submit, monitor, and document prior authorizations for medical procedures, diagnostic testing, specialty services, behavioral health services, and dental procedures requiring payer authorization.
• Communicate with insurance companies, referring providers, patients, and clinical staff regarding authorization status.
• Monitor authorization expiration dates and ensure approvals are obtained prior to scheduled services.
• Resolve insurance eligibility and authorization issues promptly to minimize delays in patient care.
• Maintain accurate documentation of all authorization within the electronic health record.

Patient Communication

• Answer incoming telephone calls promptly and professionally.
• Respond to patient inquiries or direct calls to the appropriate department.
• Monitor and manage assigned electronic work queues, appointment requests, and authorization worklists.
• Communicate effectively with providers, nurses, dental staff, behavioral health clinicians, care managers, and other departments regarding patient scheduling and access needs.
• Provide clear explanations regarding appointments, insurance requirements, and financial policies.

Care Coordination and Quality

• Support Patient-Centered Medical Home (PCMH) and integrated care initiatives by scheduling patients with their assigned primary care providers whenever possible.
• Assist in coordinating patient care between Medical, Dental, Behavioral Health, and specialty providers.
• Participate in quality improvement initiatives designed to improve patient access, satisfaction, and operational efficiency.
• Maintain accurate documentation and data entry to support quality reporting and organizational performance measures.
• Promote exceptional customer service and patient satisfaction through compassionate, respectful interactions.

Administrative Responsibilities

• Maintain confidentiality of patient information in accordance with HIPAA and organizational policies.
• Follow established workflows, policies, and procedures.
• Attend required staff meetings, department meetings, training sessions, and continuing education activities.
• Maintain a professional appearance and positive attitude.
• Demonstrate flexibility by assisting with additional duties as assigned to support patient care and departmental operations.

Knowledge, Skills, and Abilities

• Strong customer service orientation.
• Excellent verbal and written communication skills.
• Ability to work effectively in a fast-paced, integrated healthcare environment.
• Strong attention to detail and accuracy.
• Ability to exercise sound judgment and maintain professionalism.
• Ability to manage competing priorities while maintaining quality and efficiency.
• Working knowledge of medical, dental, and behavioral health terminology preferred.
• Knowledge of insurance plans, payer requirements, referrals, prior authorizations, and patient registration processes.
• Ability to establish positive working relationships with patients, providers, and coworkers.

Physical Requirements

• Ability to sit, stand, and walk throughout the workday.
• Frequent use of computers, telephones, and office equipment.
• Manual dexterity sufficient for keyboarding and operating office equipment.

Job Type: Full-time

Pay: From $22.66 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

People with a criminal record are encouraged to apply

Education:

• High school or equivalent (Required)

Language:

• Brazilian Portuguese (Preferred)

Work Location: In person

Salary : $23