Patient Access Representative

Milwaukee Health Services; Milwaukee (WI); On-site; USD 36,000 - 48,000; Full time

Job summary

Milwaukee Health Services seeks a Patient Access Representative to be the first contact for patients by phone and in person. You will collect demographics, verify insurance, schedule appointments, and collect payments while promoting excellent customer service.

The role involves using Epic for charting, assisting with the Sliding Fee Discount Program, and ensuring HIPAA/OSHA compliance as part of daily duties. On-site hours and varying shifts are expected.

Qualifications

• Education requirement: High school diploma or GED.
• 2–4 years of customer service experience; Epic experience preferred.
• Knowledge of healthcare insurance and billing processes.

Responsibilities

• Greets patients and team members with a positive attitude and demeanor; ensures a superior experience.
• Handles call management with effective listening and communication.
• Schedules and reschedules appointments using provider templates and the first available slots.
• Manages department schedules; works with clinical staff on changes and cancellations.
• Collects and verifies demographics, insurance information, and scans IDs.
• Verifies insurance using E-verification/payor portals.
• Assists with Sliding Fee Discount Program applications and documentation.
• Collects copays, deductibles, and other payments; directs to Financial Advocate as needed.
• Complies with HIPAA and OSHA; maintains a safe work environment.
• Performs other duties as assigned.

Skills

Customer service

Communication

Multitasking

Epic experience

Insurance knowledge

Education

High School diploma or GED

Tools

Epic

Job description

POSITION SUMMARY:

The Patient Access Representative (PAR) serves as the first point of contact for patients of MHSI via phone and in person. This position supports MHSI's mission to provide accessible quality health care services by promptly answering patient calls and greeting in person patients with a smile, and scheduling/rescheduling patient appointments. PARs are also responsible for obtaining required forms, demographic/insurance information, and collecting/posting patient payments. They are continually looking for new and better ways to assist their patients and strive to provide excellent customer service.

Position-Specific Competencies/Essential Functions/Duties & Responsibilities:

• Excellent customer service: Greets all patients and team members with a positive attitude and demeanor. Addresses patient needs to ensure they have a superior experience. Displays empathy, actively listens, and communicates clearly and effectively.
• Call management: Displays a natural ability for customer service, good listening skills, effective communication skills, and an enthusiastic attitude. Displays excellent critical thinking and problem-solving skills.
• Appointment scheduling: Collects all required information including a clear and concise reason for the appointment. Utilizes provider templates appropriately and offers patients first available appointments.
• Department schedule management: Reviewing provider schedules daily to reschedule no showed and canceled appointments. Reconciling the schedules throughout the day. Work with clinical staff on provider schedule additions and/or changes/cancelations.
• Accurate patient demographics: Collects and verifies patient/guarantor demographic information including name, date of birth, social security number, gender, race/ethnicity, address, phone number, emergency contact, and income. This includes scanning the patient's ID and/or any other documentation provided by the patient.
• Insurance verification: Accurate insurance and subscriber information is obtained when scheduling patient appointments. Insurance verification completed utilizing E-verification and/or payor portals.
• Sliding Fee Discount Program: Offers sliding fee program to all patients regardless of their income or insurance status. Collects applications with supporting documentation, reviews for completeness, and scans completed application packets into EHR.
• Payment collection: Collection of copays, deductibles, prepayments, and previous balances. Refers patients to the Financial Advocate to discuss payment plan/financial hardship options.
• HIPPA and OSHA compliance; always promotes a safe work environment
• Perform other duties as assigned.

Monthly Patient Access Goals

• Patient registration flow must adhere to the following standards: not to exceed 5 minutes for established patient appointments; not to exceed 7 minutes for established patient walk-in appointments; not to exceed 15 minutes for new patients.
• Pre-registration occurs at time of scheduling 100% of the time.
• Insurance verification completed 100%, not less than 97%, of the time utilizing E-verification and/or payor portals at least 1 business day prior to the scheduled appointment.
• Strive to achieve 100% (not below 75%) collections of all co-pays, co-insurance, and self-pay amounts by utilizing respectful and ethical collection practices.
• No more than 5% of contacts added to patient WQ.
• Strive to achieve 100% (not below 95%) of patients being checked in utilizing MHSI's established workflows. This is measured on the productivity score card under percentage of workflows without warnings.
• Strive to achieve 100% (not below 97%) of Medicare Secondary Payor Questionnaires (MSPQ) as established in the registration flow.
• Sliding fee applications obtained by PARs must have all supporting documents and signature of guarantor. Applications will be audited on a quarterly basis and must have a compliance rate of not less than 95%.

Position Requirements:

Education:High School degree or GED required.

Experience:2-4 years of demonstrated ability in customer service capacity. Epic experience preferred. Demonstrated knowledge and experience regarding healthcare insurance

Expertise:Ability to multitask within team settings. Strong analytical skills. Comfortable in an environment with changing prioritizes and time pressures. Ability to perform basic mathematical calculations.

Language:Comprehend and use basic language either written or spoken to communicate information and ideals.

Hours of Work:May vary based on Organizational need.

Travel:Between sites, may vary based on Organizational need.