Job Details

The Patient Access Representative Pre-Service is responsible for completing pre-service financial clearance and registration activities to ensure accurate billing and reimbursement. This role obtains and verifies insurance benefits, authorizations, diagnoses, and procedure codes; provides financial counseling to patients; collects payments; and establishes payment arrangements before service. The Representative plays a critical role in reducing denials, improving upfront collections, and supporting a positive patient experience while maintaining compliance with hospital policies and HIPAA regulations. ESSENTIAL JOB FUNCTIONS (including, but not limited to)Receive and review proposed services via phone, fax, email, or electronic worklists. Obtain and verify required pre-service documentation, including diagnoses, procedure codes, insurance eligibility, authorizations, and pre-certifications. Verify insurance benefits using Passport, payer portals, or other available resources to deter...