Patient Access Representative

vcuhealth; Fredericksburg (VA); On-site; USD 32,000 - 42,000; Full time

Job summary

VCU Health in Fredericksburg is seeking a Patient Access Representative to deliver high-quality customer service and manage front-desk functions. You will greet patients, collect co-pays, verify insurance, schedule appointments, and assist with registrations and referrals, ensuring accurate data entry and smooth workflows.

The role involves handling patient interactions, maintaining documentation, and supporting financial counseling when needed.

Qualifications

• Demonstrated experience using computers, Microsoft Office applications, and web-based platforms.
• Experience with medical insurance, HMO, managed care, electronic medical billing/order entry/registration systems, and appointment scheduling.
• Knowledge of medical terminology.

Responsibilities

• Greet Patients/Answer Telephone and provide exceptional customer service in a courteous, professional manner.
• Handle Co-payment Collection & Registration Data accurately, verify demographics/insurance, and update records.
• Manage Referral processes: verify coverage, obtain referrals/authorizations, and communicate requirements to patients.
• Schedule appointments, transcribe physician orders, coordinate pre-operative testing where appropriate.
• Maintain patient records, verify registrations, ensure patients are properly documented in scheduling systems.
• Obtain and scan patient medical documentation (E-Documents Management).
• Perform miscellaneous duties and support department projects as needed.

Skills

Computer literacy

Education

High School Diploma or equivalent

Associate or Bachelor's Degree in Accounting, Finance, Business Administration, Healthcare Administration or related field

Tools

Microsoft Office

Job description

The Patient Access Representative delivers high-quality customer service to patients of all ages, their families, visitors, medical staff, clinicians and co-workers, ensuring all interactions are courteous, timely and respectful.

The Patient Access Representative handles all business functions in an assigned clinical department area to include reception, scheduling, and registering patients for appointments and/or procedures. This position also secures the appropriate patient information; ensures that registration data is correct and accurate; validates insurance eligibility, ensuring accurate data entry; collects co-pays, and supports financial counseling and financial clearance, as necessary.

Essential Job Statements

Greet Patients/Answer Telephone

Provide s exceptional customer service by welcoming patients and visitors in a friendly , p rofessional, and respectful manner . E nsure s individuals are respected and informed, communicat ing clearly and effectively, and utilizing appropriate language resources as needed . Assist s with traffic flow in and out of the clinic as needed. Address es patient needs promptly, and maintain s a courteous, professional tone at all times .

Co-payment Collection & Registration Data

Collect s all patient co-payments and deposits accurately per payer , following department guidelines . Verifies and updates registration data, including demographic and insurance information. Copies and records insurance information per department standards. Follows department policies for cash handling, including cash reconciliation and deposit preparation .

Referral Management

Verifies insurance coverage and understands requirements for HMO, managed care, government and private plans. Secures required referrals/authorizations and links them correctly in the referral module. Obtains needed referrals and authorizations before scheduled procedures, tests , injections and surgeries. Communicates plan-specific referral/authorization requirements to patients and providers. Provides pre-payment guidance for self- pay patients and offers financial assistance. Prepares cost estimates, explains payment expectations and documents all interactions in the patient account .

Appointment Scheduling, Lab & Test Order Entry

Correctly s chedule s clinic appointments through the medical records software/communication platform . Transcrib es physician orders accurately and completely ( i.e. lab test, ancillary test) and records them in the appropriate system(s) according to the physician's instructions and VCUHS policy. Coordinat es the collection of pre-operative testing and paperwork, where appropriate .

Patient Record/Verify Registration Data

Maintains proficiency in all aspects of patient medical record keeping in an organized manner. Assist s in preparation of the chart before the patient visits . If applicable, assist s in breaking down the chart at the completion of the patient's visit. Ensur es that all patients arrived in the appointment scheduling system before the end of the appointment day. Where appropriate , appointments are documented as "no-shows" or cancellation s before the end of the appointment day. Obtain s signatures and complet es the required forms including those from managed care and other insurance plans.

E-Documents Management & Scanning

Obtains and scans all appropriate patient medical documentation .

Miscellaneous Responsibilities

Notifies supervisor of issues involving violation of VCUHS policies or procedures.
Performs other duties as assigned and/or participates in special projects to support the mission of VCUHS and department.

Patient Population: N/A

Employment Qualifications

• Education Required: High School Diploma or equivalent
• Education Preferred: Associates or Bachelor's Degree in Accounting , Finance, Business Administration, Healthcare Administration or closely related field from an accredited program.

Licensing/ Certification

• Licensure Required: N/A
• Licensure Preferred: N/A
• Certification Required: N/A
• Certification Preferred: N/A

Minimum Qualifications

• Years and Type of Required Experience:Demonstrated experience using computers, Microsoft Office applications, and web-based platforms
• Experience Preferred: Work experience with medical insurance, HMO, managed care, electronic medical billing/order entry/registration systems, and appointment scheduling.
• Previous work experience in a healthcare setting , and knowledge of medical terminology .
• Other Knowledge, Skills and Abilities Required: Able to perform daily activities with minimal supervision: being self-directed in the accomplishment of routine activities.
• Other Knowledge, Skills and Abilities Preferred: Depending on assignment, may be required to work off-shifts and/or weekend and holidays.
• Working Conditions: Periods of high stress and fluctuating workloads may occur. General office environment. May have periods of constant interruptions. Prolonged periods of working alone.

Physical Requ