Patient Access Representative Full Time

United Surgical Partners International; California (MO); On-site; USD 28,413 - 40,467; Full time

Benefits offered by this job

Health benefits

Retirement plan

Disability coverage

FSAs/HSAs

EAP

Paid holidays and vacation

Job summary

West Coast Joint and Spine Center in California seeks a Patient Access Representative to support ambulatory surgery operations. You will pre-register patients, verify demographics and insurance, obtain authorizations, and ensure accuracy of records before service.

The role requires strong communication with patients and staff, adherence to HIPAA, handling co-payments, and meeting cash collection goals. Competitive benefits and a fast-paced team environment are offered.

Qualifications

• Experience in patient registration, verification and authorization in a medical center or comparable institution.
• Working knowledge of governmental regulations and other reimbursement criteria preferred.
• Ability to accurately type 40 WPM, complete forms, simple correspondence, handle payment transactions and enter data.
• Excellent verbal and written communication and interpersonal skills required.

Responsibilities

• Communicate with clinical departments or Scheduling Representative to obtain scheduled appointments and/or orders prior to the service date.
• Pre-register 98% of all scheduled patients a minimum of three business days in advance of arrival.
• Obtain, validate and accurately enter the patient’s demographic and insurance information while maintaining an accuracy rate of 95%+.
• Thoroughly review the MPI to avoid duplicate medical record numbers.
• Obtain signatures on all necessary forms and documents.
• Verify MSP Questionnaire for Medicare registrations.
• Coordinate with physician office staff and hospital departments to schedule and prepare information before arrival.
• Verify insurance eligibility and benefits, document findings, and assist with pre-authorizations as required.
• Collect co-payments, deductibles or co-insurance at patient arrival.
• Ensure EMTALA compliance for Emergency registration when applicable.

Skills

Patient registration

Insurance verification

Authorization processing

HIPAA compliance

Multitasking

Communication skills

Education

High School diploma or equivalent

2 years college preferred

Job description

Welcome to West Coast Joint and Spine

West Coast Joint and Spine Center is hiring a Patient Access Rep. Our fast‑paced Ambulatory Surgery Center is committed to producing the highest quality work and experience for patients and their families.

What We Offer

• Medical, dental, vision, and prescription coverage
• Life and AD&D coverage
• Availability of short‑ and long‑term disability
• Flexible financial benefits including FSAs, HSAs, and Daycare FSA.
• 401(k) and access to retirement planning
• Employee Assistance Program (EAP)
• Paid holidays and vacation

Essential Functions

• Communicate with clinical departments or Scheduling Representative to obtain scheduled appointments and/or orders prior to the service date.
• Pre‑register 98% of all scheduled patients a minimum of three (3) business days in advance of their arrival.
• Obtain, validate and accurately enter the patient’s demographic and insurance information while maintaining an acceptable accuracy rate (95% plus) as evidenced by routine quality review.
• Thoroughly review the MPI so that duplicate medical record numbers are avoided.
• Obtain signatures on all necessary forms and documents required by hospital and law.
• Ensure MSP Questionnaire is completed for every Medicare registration.
• Work closely and cooperatively with the physician office staff, schedulers and other hospital departments to schedule and prepare required information before the patient’s arrival.
• Utilize online programs to verify insurance eligibility and benefits, documenting findings on the patient account. Assist by contacting the insurance company for pre‑authorizations and pre‑certifications as required prior to patient receiving service when asked by Director.
• Effectively communicate with physician office staff to resolve authorization issues and coordinate registrations as required.
• Collect co‑payment, deductible or co‑insurance previously identified by the Insurance Verification Specialist or as indicated on the insurance card or online eligibility system, when the patient arrives for service.
• If working in Emergency registration, ensure compliance with EMTALA regulation for all patients.
• Log cash collected, generate receipts, and maintain balanced cash at all times.
• Meet monthly cash collection goals as determined collaboratively by Department Director/Manager and CBO.
• Consistently obtain and copy/scan insurance cards and driver licenses.
• Resolve phone calls professionally, transferring and assisting with internal calls as needed.
• Perform the reception/greeter function at the front desk entrance as needed.
• Verify medical licensure and check Medicare Sanctions websites for non‑credentialed physicians ordering outpatient diagnostic tests (Community Hospital Only).
• Consistently demonstrate premier customer service and communication skills with all internal and external customers/contacts and ensure the patient and their family members have the best hospital encounter possible.
• Meet established quality and productivity standards for self and for the team.
• Anticipate and adapt to change in a positive manner.
• Foster and reinforce team‑based results.
• Adhere to time and attendance standards and provide proper notification of absence or tardiness within established departmental time frames.
• Ensure patient confidentiality adhering to HIPAA guidelines.
• Demonstrate the knowledge, skills, and abilities to perform the duties outlined above annually in the form of a test or daily quality review and direct observation.
• Track and monitor productivity as requested.
• Keep Department Director or Team Lead apprised of any delays in the registration process.
• Remain current on scheduling, registration, insurance verification, and other patient registration processes to cover in the absence of other team members.
• Perform other duties as assigned.

Qualifications

• High School graduate or equivalent required; 2 years college preferred.
• Experience in patient registration, verification and authorization in a medical center or comparable institution.
• Working knowledge of governmental regulations and other reimbursement criteria preferred.
• Ability to accurately type 40 WPM, complete forms, simple correspondence, handle payment transactions and enter data.
• Excellent verbal and written communication and interpersonal skills required.
• Ability to handle multiple tasks with short time‑lines, prioritize and organize work, and complete assignments in a timely and accurate manner.
• Exceptional ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, co‑workers, employers and insurance company representatives.
• Must have a pleasant disposition, positive attitude and maintain a cordial and professional approach during periods of stress.
• Skill in using office equipment: basic computer skills, photocopier, telephone, fax machine, and calculator.
• Demonstrated ability to think and act decisively in a timely manner.
• Ability to maintain operational knowledge of all insurance requirements necessary to achieve optimal reimbursement.

Pay: $25/hr