Patient access representatives serve an essential role at health-care facilities as the first point of contact when a patient calls or walks into the office. They are usually responsible for answering the phone, scheduling appointments, billing, and submitting insurance claims. Patient access representative is an entry-level position and can be a good starting point to launch a career in health care.
Sample job description
The patient access representative provides high-level administrative support to the patient access team, including completion of patient medical insurance eligibility, processing benefits, and referral authorizations for patients.You will need to complete daily patient entry, intensive care unit (ICU) listing, or census verification activities to ensure proper patient identification by collecting, entering, and verifying data in order to remove duplicate registrations, verify insurance eligibility with third-party payers, coordinate benefits information for patients/families, and file claims on behalf of the patient with various public or private health insurance carriers. You may also be tasked with updating demographic records in the computer system, maintaining family contacts with insurance companies to resolve claim and benefit issues, assisting patients with questions or concerns related to their hospital stay, or serve as a liaison between patients and other departments within the hospital.
Typical duties and responsibilities
- Answer phone and schedule appointments
- Greet patients and visitors to the office
- Record patients’ medical history and personal information
- Escort patients around the office
- Submit insurance forms
- Copy, file, and maintain paper and electronic documents
- Handle incoming and outgoing correspondence
Education and experience
Patient access representatives need to have a high school diploma or equivalent. Computer and typing skills and knowledge of the health-care industry are helpful. Employers usually provide on-the-job training that covers specific duties.
Required skills and qualifications
- Computer skills, including Microsoft Office Suite (Word, PowerPoint, and Excel)
- Experience with electronic health records (EHRs)
- Strong customer service skills for dealing with patients
- Discretion and the ability to handle confidential information
- Organization skills and the ability to multitask
- Compassion and a calm, professional demeanor
- Keen attention to detail
Preferred qualifications
- HIPAA certified
- Knowledge of insurance benefits
- 3+ years of experience working as a patient access representative
- Strong interpersonal skills
- Ability to solve claims in a fast manner
Average salary and compensation
The average salary for a patient access representative is $35,000 in the United States. Position salary will vary based on experience, education, company size, industry, and market.
| Location | Salary Low | Salary High |
|---|---|---|
| Phoenix, Arizona | $34,800 | $47,100 |
| Los Angeles, California | $39,250 | $53,150 |
| Denver, Colorado | $32,750 | $44,300 |
| Washington, DC | $39,850 | $53,950 |
| Miami, Florida | $32,600 | $44,050 |
| Orlando, Florida | $30,050 | $40,650 |
| Tampa, Florida | $31,350 | $41,050 |
| Atlanta, Georgia | $31,850 | $43,050 |
| Chicago, Illinois | $36,600 | $49,500 |
| Boston, Massachusetts | $39,550 | $53,550 |
| Minneapolis-St. Paul, Minnesota | $31,550 | $42,650 |
| New York City, New York | $41,650 | $56,350 |
| Philadelphia, Pennsylvania | $33,900 | $45,900 |
| Dallas, Texas | $33,000 | $44,700 |
| Houston, Texas | $32,750 | $44,300 |
| Seattle, Washington | $38,100 | $51,500 |
| National Average | $29,750 | $40,250 |
Typical work environment
Working as a patient access representative means you’ll be working in a medical office setting. The operating room is not considered an environment where this type of work may be performed, but you may work in a hospital, clinic, or regular office. They may also liaise with patients and other hospital departments. Patient access representatives must be able to work with insurance companies to resolve claim and benefits issues.
Typical hours
Patient access representatives typically work regular office hours, from 9 AM to 5 PM during the week. However, some medical facilities with extended hours might require evening and weekend shifts.
Available certifications
Though it’s not required to receive certifications, securing one can help you stand out from the other applicants. The most popular certification is:
- Certified Healthcare Access Associate (CHAA) – This certification validates that your knowledge and skills align with industry standards – showing that you are a reliable, accountable, and trusted patient access professional dedicated to improving patient experience.
Career path
The first step to becoming a patient access representative is to earn a high school diploma or equivalent. Solid communication and computer skills, along with the ability to type, are helpful. Employers also prefer candidates with some knowledge of health care, although they usually provide on-the-job training for their specific needs.
US, Bureau of Labor Statistics’ job outlook
SOC Code: 29-2098
| 2020 Employment | 335,000 |
| Projected Employment in 2030 | 363,600 |
| Projected 2020-2030 Percentage Shift | 9% increase |
| Projected 2020-2030 Numeric Shift | 28,600 increase |
Position trends
Patient access representative is an entry-level position, and some people use it as a springboard to other jobs with more responsibility in the health-care industry. Candidates with computer and database skills will have the upper hand. The aging population means demand for health care workers should remain robust.
The American Society of Administrative Professionals provides training and resources for people who work in this field.
Sample interview questions
- What experience do you have working with patients and their insurance?
- How would you go about verifying a patient’s insurance eligibility?
- What are some of the challenges that come with working in patient access?
- What do you find to be the most rewarding aspect of this role?
- Describe a situation when you resolved a challenge.
- What are the biggest problems facing patient access in healthcare?
- How would you go about updating a patient’s demographic information?
- Where do you see the future of patient access going within the next ten years?
- What experience would make an ideal candidate for this role?
- Tell me about your availability and typical work schedule.
- What is your availability for overtime?
- Tell me about a time when you had to go above and beyond your job duties.
- What is the most difficult thing about this role?
- What are some of the biggest changes that you have seen in patient access over the years?
- How would you go about communicating with someone on the phone when they are upset?
