Patient Access Representative Job Descriptions, Average Salary, Interview Questions

What Does a Patient Access Representative Do?

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.

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National Average Salary

Patient access representative salaries vary by experience, industry, organization size, and geography. To explore salary ranges by local market, please visit our sister site zengig.com.

The average U.S. salary for a Patient Access Representative is:

$35,210

Patient Access Representative Job Descriptions

Example 1

Responsible for patient registration, admissions, and associated tasks which include information collection and validation, and requisitioning of orders and services. Insurance-related tasks include: verification, collection of co-payments, and collection of associated paperwork. Performs administrative functions, scheduling, answering phones, and coordinating general requests.

Job duties

  • Registers patients and performs all registration-related functions, including explaining and obtaining all necessary patient consents and authorizations in a complete and timely manner, collecting financial paperwork (e.g., patient responsibility statement, etc.), and co-payment as required
  • Communicates effectively with patient to assist in access to care by: answering telephone and other incoming communications in a timely and customer-service oriented manner; replying to inquiries, patient needs for information, and other parties clearly and in a timely manner; and, if information is not readily available, follows up with inquiries to responsible party
  • Resolves all non-clinical questions within scope of knowledge while providing excellent customer service on the phone and/or in person
  • Performs on-going documentation audits for medical necessity, plan of care, and other related tasks or requirements by payors, including Medicare, using a variety of computer-based systems
  • If in a procedure-based department, routinely schedules appointments for all procedures educating each patient with pre-exam and if necessary, post-exam requirements within scope. Organizes, generates and distributes patient reminders, results, and recall letters
  • Establishes files, maintains information, and scans medical records in a timely and organized manner
  • Manages, directs and responds to incoming office correspondence as deemed appropriate, including mail, email, faxes, and telephone calls, and forward queries to the appropriate staff
  • Organizes, monitors, and orders front desk supply inventory to assure cost effective departmental spending
  • Attends and provides feedback for departmental staff meetings
  • Follow the Center for Medicare & Medicare Services (CMS) requirements for checking medical necessity communicates relevant coverage/eligibility information to the patient. Identifies patients who will need Medicare Advance Beneficiary Notices (ABNs) of non-coverage and maintains accurate records of authorizations within the EM
  • Completes Medicare Secondary Payer Questionnaire for Medicare beneficiaries in accordance with Centers for Medicare & Medicaid Services (CMS) standards
  • Role Models the Principals of a Just Culture and Organizational Values
  • Ensures compliance with all applicable HIPAA, EMTLA and Joint commission requirements, providing required associated literature to patients
  • Performs other duties as assigned on department and organizational-level

Qualifications

  • Experience in healthcare preferred.
  • Previous admitting or clerical experience, and medical terminology are preferred

Example 2

Responsible for front line support to the department. Coordinates and performs front line office activities in an effective and efficient manner for the department. Greets and registers incoming patients, supports the patient check out process and schedules future appointments as applicable.

Job duties

  • Hours: 0800-1630; may work 0730-1600, 0800-1630, or 0830-1700
  • 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, as well as 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
  • 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

Example 3

The Patient Access Representative must be self-driven and able to multitask and prioritize their work. They must have strong communication skills and be able to deal effectively with others. This position is team-oriented and contributes to achieving department goals. In addition, Patient Access Representatives must answer all incoming calls on the hospital switchboard and transfer as appropriate.

Duties and responsibilities

  • Obtain accurate and complete demographic and financial information from patients or their representatives through established screening techniques
  • Electronically verify patients’ insurance coverage and refer to financial counselor if needed
  • Present, explain, and obtain appropriate signatures for legal and compliance related documents
  • Scan necessary documents into electronic health record
  • Schedule patient appointments or tests/procedures by interpreting physician orders, by patient need, or by established protocols. Provide patient with instructions or preparation for the test/procedure
  • Focus on the patient at each interaction, prioritizing tasks with emphasis on patient needs and processing patients using critical thinking skills
  • Welcomes all patients and visitors with a smile and provide a positive first impression for the Health System. Provides the requested information and assists to appropriate areas as needed
  • Effectively communicate in a timely professional manner
  • Answers phone calls promptly and courteously. Directs calls appropriately for patient assistance
  • Answers phone calls promptly and courteously. Directs calls appropriately for patient assistance
  • Collect copays and payments according to policy. Balance drawer daily. Follow department/clinic cash handling policy

Required education

  • Completed 3 years of high school; High School Diploma or GED

Required experience

  • 0-2 years hospital clerical, general clerical or customer service related position; Must be able to type 40 words per minute

How to Hire a Patient Access Representative

Consider the following when hiring a patient access representative:

  • Recruiting: Do you have the internal resources and tools to source and recruit for this role successfully?
  • Complexity: Do you need a senior professional, or will mid, or even junior-level skills suffice?
  • Duration: Is this a one-time project, or an indefinite need?
  • Management: Can you effectively direct the work effort?
  • Urgency: Are there any deadlines associated with this need?
  • Headcount: Do you have the budget and approval for an internal employee, or should you consider alternate options?

Answering these questions will help determine the best course of action for your current hiring need. Fortunately, various great options exist for every scenario, no matter how unique. We recommend the following options when hiring a patient access representative:

1. Use 4 Corner Resources (or another professional recruiting firm)

The heavy lifting is done for you when working with a top-tier staffing company like 4 Corner Resources. We source, screen, recruit, and deliver only the most qualified candidate(s), saving you significant time and effort throughout the hiring process while you remain focused on your core business. Understanding your needs and ensuring the right candidate for the position is the key to our success.

This is the best route to take when:

  • You need to fill the position quickly
  • You want access to a vast talent pool of high-quality, prescreened candidates
  • Your position is suited for temporary hiring services, contract staffing, or contract-to-hire recruiting, and you intend to direct the work activity.
  • You are hiring an employee as a direct placement but aren’t able to recruit effectively or efficiently with your internal staff. 
  • You aren’t familiar with current salary rates, market trends, and available skill sets
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2. Advertise your opening on a top job board

Your best option may be to advertise your opening on a proven job board. There are many widely used job sites out there that draw visits from qualified candidates. If you have someone internally who can dedicate the time and energy to sort through applications and screen individuals effectively, this can be a great choice. 

We recommend using a job board when:

  • Your internal recruiting team has the knowledge and experience to assess candidate qualifications
  • You are hiring a direct employee and have time to manage the entire recruiting effort 
  • You have a process for receiving, screening, and tracking all resumes and applications
  • You are prepared to respond to all applicants

There are many career sites out there. Here are the two we recommend for a patient access representative opening:

LinkedIn

LinkedIn is a social network for job seekers, professionals, and businesses. With this popular job site, you can enhance your brand and advertise your open position to a wide audience of motivated, qualified candidates. Job postings on LinkedIn are also extremely streamlined and user-friendly, making it even easier for candidates to apply. Additionally, applicants can use their LinkedIn profile instead of a resume to expedite the process. 

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CareerBuilder

CareerBuilder has been a trusted source for hiring since 1995. Reach 80+ million unique, diverse U.S. job seekers annually by posting your jobs through their talent acquisition channels. Through CareerBuilder, you can engage candidates and drive them into your sourcing pipeline. We recommend using CareerBuilder for hiring when you have the internal resources and processes to review, screen, and reply to all applicants.

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3. Leverage your internal resources

You can utilize your own website, social media, and employees to assist in your search for top candidates. 

A company website posting should be the first step in notifying prospective candidates that you are hiring. Social media can also be a powerful tool for spreading the word about your new opening. As far as exposure is concerned, this option can be as good as some job boards when you have a large enough following across various platforms, like LinkedIn, Instagram, Facebook, TikTok, and Twitter.

Current employees are every organization’s greatest asset. Encourage your internal team to promote job openings to their network by offering cash and other incentives.

We recommend these options when:

  • Your brand has great name recognition
  • You can consistently monitor and respond to candidate activity through your website and social media accounts
  • You have a process in place to quickly and broadly communicate job openings and requirements
  • You have an effective employee referral program in place

If you aren’t sure which path is best, schedule a discovery call today with our seasoned recruiting professionals. The 4 Corner team is on standby to help you find the best option for your unique hiring need.

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?

Need help hiring a Patient Access Representative?

We match top professionals with great employers across the country. From filling urgent job openings to developing long-term hiring strategies, our team is here to help. Review our staffing solutions, browse our award-winning Staffing Corner blog, or call today. We look forward to connecting with you soon.

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