Job Description

Responsibilities:

Job Summary:

The Patient Access Representative serves as a key point of contact for patients by collecting and validating patient information, coordinating scheduling activities, verifying insurance coverage, and supporting accurate registration and billing processes. This role promotes a positive patient experience through financial counseling, patient engagement, appointment management, and navigation assistance while ensuring compliance with HIPAA regulations and organizational standards.

Key Responsibilities:

1. Obtains required information for hospital and physician records, governmental requirements, billing and third-party payer needs. Enters accurate patient information into the electronic health record.
2. Maintains confidentiality of patient information and complies with HIPAA regulations.
3. Correctly transcribes and validates patient orders.
4. Schedules, re-schedules, and cancel appointments in the electronic health record at the request of the patient, receiving department or ordering provider.
5. Verifies and correctly assigns insurance coverages based on eligibility responses.
6. Creates a transparent financial experience including generation of estimate, explains patient liability, and collects prepayments and/or outstanding balances.
7. Monitors and resolves errors in assigned workqueues.
8. Advocates for patient engagement, including activation of MyChart.
9. Assists with wayfinding and connecting patient to care.
10. Performs additional duties as assigned to support departmental and organizational goals.

Reports To: Patient Access Supervisor

Supervises Others: No

Prepared Date: 11/2024

Review/Revision Dates: 08/2018, 08/2019, 07/2023, 11/2024

Qualifications:

Education & Experience:

• High school diploma or GED preferred. In lieu of high school diploma or GED, experience in a related field may be considered.
• Prior healthcare, medical office, or insurance experience preferred.

Licenses & Certifications:

• N/A

Essential Skills:

• Basic data entry and computer skills, including Microsoft Office products.
• Ability to work in a fast-paced metric driven environment that is patient centered.
• Fundamental understanding of KPI’s and thresholds to measure productivity.

Requirements:

High School Diploma/GED

Founded in 1906, McLeod Health is a locally owned and managed, not for profit organization supported by the strength of more than 900 members on its medical staff and more than 2,900 licensed nurses. McLeod Health is also composed of approximately 15,000 team members and more than 90 physician practices throughout its 18-county service area. With seven hospitals, McLeod Health operates three Health and Fitness Centers, a Sports Medicine and Outpatient Rehabilitation Center, Hospice and Home Health Services. The system currently has 988 licensed beds, including Hospice and Behavioral Health. The hospitals within McLeod Health include: McLeod Regional Medical Center, McLeod Health Dillon, McLeod Health Loris, McLeod Health Seacoast, McLeod Health Cheraw, McLeod Health Clarendon and McLeod Behavioral Health.