Patient Access Representative-West Houston

Must complete the survey for further consideration:

Patient Access Representative Questionnaire - Fill out form

SUMMARY:

The Patient Access Representative serves as the first point of contact for patients and plays a key role in ensuring a positive, efficient experience. This position is responsible for welcoming patients, managing check-in and check-out processes, verifying insurance and demographic information, scheduling appointments, and supporting daily clinic operations. The role requires strong communication skills, attention to detail, professionalism, and adherence to HIPAA guidelines. The Patient Access Representative supports both patients and the clinical team by maintaining accurate records and providing exceptional customer service in a fast-paced healthcare environment.

QUALIFICATIONS:

• High school diploma/GED
• Bilingual English & Spanish
• 1-year medical office experience (Required)

6 months Customer Service in Medical Office (Preferred)

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Patient Experience & Professionalism

• Greet patients and provide a positive, welcoming, and respectful environment.
• Respond to patient questions or concerns promptly and courteously.
• Observe patients in the waiting room and report any apparent illness or distress to clinical staff.
• Maintain strict compliance with HIPAA regulations and protect all patient information with complete confidentiality at all times.

2. Patient Check-In/Out & Verification

• Ensure all patient demographic information is reviewed, verified, and updated at every visit.
• Confirm insurance information, eligibility, and any necessary updates.
• Ensure required documents are signed by the patient, collected, and scanned appropriately at the time of check-in.
• Manages check-out tasks such as verifying charges, collecting copays or balances, scheduling follow-ups, and answering patient questions.

3. Scheduling & Communication

• Schedule appointments according to clinic guidelines.
• Communicate appointment policies clearly to patients.
• Call patients to confirm appointments for the next day.
• Answer phone calls in a courteous and professional manner.
• Relay messages to clinical and administrative staff in a timely manner.

4. Insurance & Billing Support

• Follow all protocols for insurance updates to prevent claim errors and denials.
• Accurately enter and verify insurance information and PCP assignment.
• Attempt to collect copays, coinsurance, previous balances, and/or record charges.
• Process any charge entries into the EMR system.
• Clearly explain patient responsibility according to insurance benefits or sliding fee scale eligibility.
• Scan and fax provider change form to the appropriate payer on the same DOS.

5. Workflow Compliance

• Complete all required tasks each shift without delegating duties to others.
• Adhere to established processes, even during busy periods.
• Maintain professionalism and accuracy in all data entry.
• Travel to and provide coverage at other clinic locations as needed.
• Participate in Compliance, Risk and Safety, Quality Assurance, and Performance Improvement Activities.

Insurance & Protection

• Health insurance
• Dental insurance
• Vision insurance
• Life insurance
• Short-term disability insurance
• Long-term disability insurance
• Critical Illness
• Hospital Indemnity

Time Off & Professional Growth

• PTO plus paid holidays
• Additional PTO accrual based on years of service
• Employee Assistance Program (EAP)