Patient Access Representative

Job title: Patient Access Representative

About the Role This PRN Patient Access Representative is responsible for completing patient registrations and providing administrative support for the Shelby Rural Health Clinic. The role collects and validates patient demographics and insurance information, verifies authorizations and referrals as required, and enters data into the registration system. It also informs patients of estimated service liabilities, collects payments, and refers patients to financial counseling as needed.

What You'll Do

• Prioritize and complete registrations in order of acuity and department protocol.
• Interview patients or family members to gather demographic, insurance, and visit-specific information, verify data from prior visits or preregistration, and input critical data elements.
• Launch insurance verification to confirm eligibility and benefits; calculate and communicate out-of-pocket liability.
• Collect and process payment for current services and any previous balances in line with cash management policies.
• Identify self-pay patients and refer to financial counseling per department procedures.
• Maintain knowledge of Medicare, Medicaid, third-party payer requirements, pre-authorization/referral guidelines, and current accepted plans.
• Proactively communicate issues involving customer service and process improvements to leadership.
• Meet productivity and quality requirements; work independently and as part of a team.
• Develop and maintain knowledge to identify insurance plans in systems and understand contract requirements to ensure accurate information.
• Provide administrative services to support effective operations in assigned areas.
• Maintain regular attendance and adhere to department scheduling.
• Other duties as assigned consistent with knowledge, skills and abilities.

What We're Looking For

• Related coursework beyond high school or experience in a complex administrative support position.
• Previous experience in registration, financial clearance or patient financial services with strong working knowledge of healthcare insurance and benefits preferred.
• Associate’s or Bachelor’s degree preferred.
• Minimum of one year of experience in a customer service-focused role.
• Knowledge and understanding of medical terminology and medical coding preferred.
• Patient Access experience (scheduling/registration/financial clearance), insurance verification, billing or certified medical assistant experience preferred.
• Proficiency with Microsoft Office Suite and ability to learn other software as needed.
• Excellent organizational skills, detail-oriented, self-starter with critical thinking, and the ability to set priorities; works well in a team and independently.
• Commitment to confidentiality; excellent verbal and written communication; strong interpersonal skills to manage sensitive situations with tact and professionalism.

Nice to Have

• Associate’s or Bachelor’s degree preferred.
• Experience with medical terminology and coding preferred.
• Patient Access/insurance verification experience preferred.
• Proficiency with Microsoft Office Suite and ability to learn other software.

Compensation & Benefits

• PRN employees can participate in a matching 401(k) plan and have access to the Employee Assistance Program.
• May qualify for hourly differential pay for certain shifts; pay rates and scheduling practices may vary by department.