Patient Access Representative - Specialty Clinics

Geisinger; Wilkes-Barre (Luzerne County); On-site; USD 36,000 - 52,000; Full time

Benefits offered by this job

Health benefits starting day one

Three medical plan choices

HSA/FSA accounts

Company-paid life insurance

401(k) with Geisinger contributions

Generous PTO

Tuition reimbursement up to $5000

Wellness program

Family-friendly support

Employee Assistance Program

Job summary

Geisinger in Wilkes-Barre, PA is seeking a Patient Access Specialist to manage the front desk check-in process, verify demographics, and explain charges and insurance requirements to patients.

The role ensures HIPAA compliance, accurate data entry, and coordination of follow-up appointments, referrals, and pre-certifications while maintaining high levels of patient service and confidentiality.

Qualifications

• Verifying demographics and completing check-in procedures.
• Interpreting insurance responses and determining primary/secondary/tertiary coverage.
• Ensuring patient privacy and HIPAA compliance at all times.

Responsibilities

• Check-in patients for appointments and verify demographics.
• Read and interpret insurance responses and assign coverage per encounter.
• Ensure disclosure forms, privacy notices, and signatures are collected.
• Explain financial obligations and collect fees at time of service.
• Schedule follow-up appointments including referrals or ancillary services.
• Process messages related to appointments, referrals, prescriptions, and complaints.

Skills

Patient check-in

Insurance verification

HIPAA compliance

Cash posting

Medical record maintenance

Tools

EHR systems

Job description

• Responsible for checking patients in for appointments and accurately verifying demographics.
• Assures all check-in procedures are completed and monitors patient wait times, communicating changes to the patient as necessary.
• Reads and interprets insurance responses.
• Understands general guidelines and insurance rank requirement to properly assign primary, secondary, and tertiary insurance per encounter.
• Ensures patient receives necessary disclosure and privacy information, obtains necessary legal and financial signatures.
• Communicates financial obligations to patients and collects fees at time of service as appropriate.
• Communicates the purpose of and completes all necessary regulatory forms with patient.
• Completes patient's visit by scheduling any necessary follow up appointments to include any specialty or ancillary services as possible.
• Processes multi-channel messages related to patient and/or physician requests regarding: appointments, referrals, prescriptions, and complaints.
• Notifies patient or guarantor of anticipated financial responsibility including copays, deductibles, or coinsurances and collects accordingly.
• Performs cash posting following department guidelines.
• Abides by organizational and HIPAA guidelines, privacy practices, patient confidentiality and patient rights.
• Independently works work queues to ensure timely resolution of all accounts.
• Maintain productivity and quality performance expectations
• Must maintain high regard for confidentiality.
• Accurately performs medical record maintenance and releases.
• Assists with referrals and pre-certifications, at the time of encounter.
• Properly utilizes and maintains patient recall and reschedule lists.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Benefits of working at Geisinger:

• Full benefits (health, dental and vision) starting on day one
• Three medical plan choices, including an expanded network for out-of-area employees and dependents
• Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) anda health savings account (HSA)
• Company-paid life insurance, short-term disability, and long-term disability coverage
• 401(k) plan that includes automatic Geisinger contributions
• Generous paid time off (PTO) plan that allows you to accrue time quickly
• Up to $5,000 in tuition reimbursement per calendar year
• MyHealth Rewards wellness program to improve your health while earning a financial incentive
• Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones
• Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more.
• Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance