Patient Access Representative

Position Purpose

The Patient Access Representative exists to ensure every patient experiences a seamless journey from appointment scheduling through check-in and check-out while maintaining the integrity of patient information, supporting revenue cycle processes, and contributing to clinic efficiency.

Essential Responsibilities

Patient Reception & Customer Service

• Greet every patient and visitor with professionalism, courtesy, and compassion.
• Create a welcoming environment that reflects the organization's commitment to exceptional care.
• Verify patient identity using established patient identification standards.
• Maintain patient confidentiality in accordance with HIPAA regulations.
• Address patient questions or concerns professionally and escalate issues appropriately.
• Assist patients with forms, portal enrollment, and office procedures.
• Maintain a clean, organized, and professional reception area.

Patient Registration

• Register new patients accurately in the electronic medical record.
• Update demographics at every visit.
• Verify: 
  • Address
  • Phone numbers
  • Email
  • Emergency contacts
  • Preferred pharmacy
  • PCP information
  • Insurance information
• Obtain required identification and insurance cards.
• Scan documentation into the EMR accurately.
• Ensure all required consent forms are completed.

Appointment Scheduling

• Schedule appointments according to provider templates and scheduling guidelines.
• Schedule follow-up appointments before patient departure.
• Coordinate referrals and specialty appointments when appropriate.
• Assist with waitlists and appointment optimization.
• Identify scheduling opportunities to improve provider utilization.
• Follow organizational scheduling protocols.

Insurance & Financial Responsibilities

• Verify insurance eligibility.
• Confirm referrals and authorizations are in place when required.
• Explain patient financial responsibilities.
• Collect: 
  • Copays
  • Deductibles
  • Coinsurance
  • Self-pay balances
  • Outstanding patient balances
• Process payments accurately.
• Balance daily cash drawer.
• Prepare end-of-day reconciliation.
• Follow financial policies consistently.

Patient Check-In

• Complete accurate patient check-in.
• Confirm insurance eligibility.
• Review required forms.
• Verify appointment details.
• Notify clinical staff of patient arrival.
• Manage patient wait times.
• Communicate delays professionally.

Patient Check-Out

• Schedule follow-up appointments.
• Provide visit summaries.
• Collect outstanding balances.
• Coordinate referrals, imaging, and laboratory appointments.
• Ensure all orders are completed before patient departure.
• Educate patients on next steps.

Electronic Medical Record Responsibilities

Maintain complete and accurate documentation.

Accurately:

• Register patients
• Update demographics
• Scan records
• Upload insurance cards
• Attach referrals
• Process patient forms
• Maintain electronic records

Communication Responsibilities

Communicate effectively with:

• Providers
• Medical Assistants
• Nurses
• Billing Department
• Referral Coordinators
• Call Center
• Patients
• Families

Maintain professionalism in all interactions.

Revenue Cycle Support

Support front-end revenue cycle initiatives by ensuring:

• Accurate insurance information
• Correct PCP assignment
• Referral accuracy
• Financial collections
• Registration accuracy
• Insurance verification
• Demographic accuracy

Recognize issues that may affect reimbursement and communicate them proactively.

Performance Expectations

The Patient Access Representative is expected to consistently achieve organizational standards in the following areas:

Registration Accuracy

• Patient demographics ≥ 98%
• Insurance accuracy ≥ 98%
• Documentation completeness ≥ 98%

Financial Performance

• Point-of-service collections
• Accurate payment posting
• Daily reconciliation accuracy

Scheduling

• Appointment accuracy
• Template adherence
• Reduced scheduling errors
• Provider utilization support

Customer Service

• Professional communication
• Positive patient interactions
• Patient satisfaction
• Timely issue resolution

Operational Excellence

• Timeliness
• Attendance
• Teamwork
• Adaptability
• Accountability

Required Qualifications

• High School Diploma or GED
• Minimum two years of medical office experience
• Experience with electronic medical records (eClinicalWorks preferred)
• Insurance verification experience
• Medical scheduling experience
• Basic medical terminology
• Computer proficiency

Preferred Qualifications

• Multi-specialty medical practice experience
• Front-end revenue cycle experience
• Prior authorization experience
• Referral management experience
• Cash handling experience
• Bilingual (English/Spanish) preferred

Knowledge & Skills

• Exceptional customer service
• Professional communication
• Medical terminology
• Insurance knowledge
• Scheduling accuracy
• Organizational skills
• Time management
• Conflict resolution
• Attention to detail
• Problem solving
• Computer proficiency
• EMR proficiency
• Multitasking
• Team collaboration

Physical Requirements

• Prolonged sitting and standing
• Frequent computer use
• Ability to lift up to 20 pounds
• Ability to move throughout the clinic
• Frequent telephone communication

Core Competencies

The Patient Access Representative is expected to embody Wellspire Medical's core values:

• Compassion – Treat every patient with dignity, empathy, and respect while delivering exceptional customer service.
• Collaboration – Work effectively with providers, clinical staff, and administrative teams to create a seamless patient experience.
• Accountability – Ensure the accuracy of patient information, insurance verification, scheduling, and financial collections while taking ownership of responsibilities.
• Empowerment – Educate patients, solve problems proactively, and support team success through initiative and continuous learning.
• Innovation – Embrace technology, improve workflows, and contribute ideas that enhance efficiency and patient access.
• Communication – Communicate clearly, professionally, and respectfully with patients, families, coworkers, and external partners.

Schedule & Compensation:

Full-time position; occasional overtime may be required.
Schedule: Monday thru Friday