Job Description - Patient Access Representative

3391852 Patient Access Representative, Worcester, MA 3 months
Sigma Systems is currently looking for a Patient Access Representativeto work with the Revenue Cycle at UMASS in Worcester, MA.

Shift Timings: 08.30 AM- 5:00 PM, 40 hpw, includes a 30 min break.
Weekend and Holiday Rotation Required
Full-Time | Monday – Friday
13-week contract with the possibility to extend and/or convert to a permanent position based on performance and business need.

Key Responsibilities:

  • Greet patients and visitors for scheduled and urgent appointments.
  • Verify patient demographics and insurance information.
  • Collect co-payments and obtain treatment and billing authorizations.
  • Assess patient needs and coordinate referrals for financial counseling, interpreter services, and social services.
  • Answer, screen, and route incoming phone calls.
  • Schedule routine and urgent appointments, procedures, diagnostic testing, and ancillary services.
  • Coordinate appointments involving multiple providers and treatment areas.
  • Prioritize scheduling to maximize patient care and provider efficiency.
  • Provide patients with verbal and written preparation instructions for procedures and testing.
  • Obtain insurance prior authorizations, pre-certifications, and referrals.
  • Verify insurance eligibility and resolve discrepancies.
  • Facilitate prescription renewal requests within established guidelines.
  • Prepare patient information for provider visits.
  • Update electronic medical records accurately and timely.
  • Review billing discrepancies and assist with corrections.
  • Maintain accurate records, logs, scheduling documentation, and patient files.
  • Perform administrative duties including faxing, scanning, filing, mail distribution, spreadsheets, and data entry.
  • Prepare reports and spreadsheets as requested by providers or leadership.
  • Process patient co-payments and maintain accurate reconciliation records.
  • Compose routine correspondence and standard patient communications.
  • Support clinicians, residents, and staff with day-to-day administrative functions.

Important Callouts:

  • Healthcare scheduling experience is required.
  • Experience scheduling procedures, imaging, specialty appointments, or ancillary services is highly preferred.
  • This is a back-office scheduling role, not a front desk receptionist position.
  • Position is primarily phone-based in a high-volume ambulatory scheduling environment.
  • * Candidates must be local and available to interview onsite.

Ideal Candidate Profile:
Our strongest candidates typically have:

  • 3+ years of healthcare scheduling experience (or 1+ year with an Associate's or Bachelor's degree)
  • Patient Access Representative, Medical Scheduler, or Scheduling Coordinator experience
  • Experience scheduling procedures, imaging, specialty clinics, surgery, GI/endoscopy, or multiple-provider appointments
  • Experience with insurance verification, referrals, and prior authorizations
  • EPIC or comparable EMR experience
  • Strong phone and customer service skills with experience in a high-volume scheduling environment
  • Ability to multitask, prioritize, and work independently in a fast-paced setting


CANDIDATES WHO ARE TYPICALLY NOT A FIT:

  • Front desk receptionists whose primary duties are check-in/check-out with limited scheduling responsibilities
  • Candidates without healthcare scheduling experience
  • Candidates without experience handling insurance verification, referrals, or prior authorizations
  • Candidates seeking primarily Medical Assistant or direct patient care roles
  • Candidates without experience working in a high-volume phone or scheduling environment


REQUIRED QUALIFICATIONS:
EDUCATION:

  • High School Diploma or equivalent Required
  • Associate or bachelor's degree Preferred

REQUIRED EXPERIENCE:

  • Minimum **3 years of related healthcare scheduling experience**
  • Requirement waived for candidates with an Associate's or Bachelor's degree and at least 1 year of recent healthcare scheduling experience.
  • Experience scheduling patient appointments in a healthcare setting.
  • Experience with insurance verification.
  • Experience obtaining referrals and/or prior authorizations.
  • Experience working in a high-volume phone environment.

PREFERRED EXPERIENCE:

  • Patient Access Representative experience
  • Medical Scheduler or Scheduling Coordinator experience
  • Procedural, specialty clinic, imaging, radiology, GI/endoscopy, or surgery scheduling
  • EPIC experience

TECHNICAL SKILLS:

  • EPIC or comparable EMR/EHR experience
  • Healthcare scheduling software
  • Microsoft Office Suite
  • Strong computer and data entry skills
  • Multi-line phone systems

OTHER REQUIREMENTS:

  • Excellent communication and interpersonal skills
  • Strong organizational and multitasking abilities
  • Ability to prioritize multiple scheduling requests simultaneously
  • Professional demeanor with exceptional customer service
  • Ability to work independently under pressure
  • Strong attention to detail
  • Ability to maintain HIPAA compliance and patient confidentiality
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