Patient Access Representative - Pre-Service

The Spine Hospital Of Louisiana; Baton Rouge (LA); On-site; USD 36,000 - 48,000; Full time

Job summary

The Spine Hospital Of Louisiana is seeking a Patient Access Representative – Pre-Service to perform pre-service financial clearance and registration, verify insurance, and counsel patients on financial responsibilities. This role supports accurate billing, reduces denials, and improves upfront collections while upholding HIPAA compliance.

The candidate will enter demographic and insurance data, obtain necessary authorizations, collect payments, and communicate with clinics to resolve

Qualifications

• High school diploma or equivalent is required.
• Minimum of 2 years in healthcare scheduling or pre-registration preferred.
• Experience with registration, insurance verification, financial counseling, and customer service is strongly preferred.

Responsibilities

• Receive and review proposed services via phone, fax, email, or electronic worklists.
• Obtain and verify pre-service documentation including diagnoses, procedure codes, insurance eligibility, authorizations, and pre-certifications.
• Verify insurance benefits to determine coverage and patient responsibility.
• Complete pre-registration by entering demographic, insurance, financial, and medical information and creating patient accounts.
• Counsel patients regarding insurance coverage, estimates, deductibles, and out-of-pocket responsibility.
• Collect pre-service payments and past-due balances and establish payment plans when appropriate.
• Communicate with clinic staff and physician offices to obtain authorization and pre-cert information and resolve discrepancies.
• Document all verification, authorization, and patient communications clearly in the patient account.
• Notify leadership of unusual cases or coverage issues requiring escalation.
• Maintain a high degree of accuracy and timeliness in all pre-service activities.
• Interact professionally with patients, families, providers, and internal departments.
• Provide backup support for other Patient Access or Revenue Cycle functions as needed.
• Maintain patient confidentiality and comply with HIPAA and privacy regulations.

Skills

Customer Service

Communication

Attention to Detail

Financial Counseling

Education

High School Diploma or Equivalent

Job description

Description The Patient Access Representative – Pre-Service is responsible for completing pre-service financial clearance and registration activities to ensure accurate billing and reimbursement. This role obtains and verifies insurance benefits, authorizations, diagnoses, and procedure codes; provides financial counseling to patients; collects payments; and establishes payment arrangements before service. The Representative plays a critical role in reducing denials, improving upfront collections, and supporting a positive patient experience while maintaining compliance with hospital policies and HIPAA regulations.

Description The Patient Access Representative – Pre-Service is responsible for completing pre-service financial clearance and registration activities to ensure accurate billing and reimbursement. This role obtains and verifies insurance benefits, authorizations, diagnoses, and procedure codes; provides financial counseling to patients; collects payments; and establishes payment arrangements before service. The Representative plays a critical role in reducing denials, improving upfront collections, and supporting a positive patient experience while maintaining compliance with hospital policies and HIPAA regulations.

ESSENTIAL JOB FUNCTIONS (including, But Not Limited To)

• Receive and review proposed services via phone, fax, email, or electronic worklists.
• Obtain and verify required pre-service documentation, including diagnoses, procedure codes, insurance eligibility, authorizations, and pre-certifications.
• Verify insurance benefits using Passport, payer portals, or other available resources to determine coverage and patient responsibility.
• Complete pre-registration by accurately entering demographic, insurance, financial, and medical information and creating patient accounts in the system.
• Counsel patients regarding insurance coverage, estimates, deductibles, co-insurance, and out-of-pocket responsibility.
• Collect pre-service payments and past-due balances and establish payment plans when appropriate.
• Communicate with clinic staff and physician offices to obtain authorization and pre-certification information and resolve discrepancies.
• Document all verification, authorization, and patient communications clearly and accurately in the patient account.
• Notify the Revenue Cycle Coordinator or Director of unusual cases, coverage issues, or extenuating circumstances requiring escalation.
• Maintain a high degree of accuracy and timeliness in all pre-service activities.
• Interact professionally and courteously with patients, families, providers, and internal departments.
• Provide backup support for other Patient Access or Revenue Cycle functions as needed.
• Maintain patient confidentiality and comply with all federal and state privacy regulations, including HIPAA.
• Support SHOLA’s culture of exceptional patient satisfaction and accountability.
• Performs special projects and other duties as assigned.

Requirements

Education

• High school diploma or equivalent required.

Experience

• Minimum of two (2) years of experience in healthcare scheduling or pre-registration preferred.
• Experience with registration, insurance verification, financial counseling, and customer service is strongly preferred.

Unique Skills

• Strong customer service and communication skills in a healthcare setting.
• Ability to read, interpret, and apply CPT codes, diagnoses, and procedures.
• High attention to detail and accuracy.
• Ability to discuss financial responsibility with patients in a clear, compassionate manner.

Reports To:

Patient Access Assistant Director

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, marital status, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by federal, state, or local law. Our company values diversity and inclusion, and we encourage all qualified applicants to apply for job openings.