Patient Access Representative

Job Description

Job Description3391852 Patient Access Representative , Worcester, MA 3 months
Sigma Systems is currently looking for a Patient Access Representative to 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