Patient access employees need in-depth familiarity with systems, customer service skills, and comprehensive knowledge of the revenue cycle to advance, according to revenue cycle leaders. Employees can:

  • apply for available revenue cycle jobs outside their departments;
  • ask to cover shifts in other areas;
  • take courses in public speaking and communications.


Patient access employees at Riverside Regional Health System in Newport News, VA, are promoted based on a new tier system implemented in December 2014.

“We re-evaluated all employees and placed them in the new tier, based on the required criteria,” says Robin Woodward, CHAM, system director of patient access.

All employees in patient access, customer service, patient accounting, scheduling, insurance verification, and healthcare information and management systems were categorized in one of three tiers based on experience, education, and certifications. (See tiers used by the department for patient access and customer service positions included in this issue.)

Patient accounting, the Call Center, and insurance verification are revenue cycle departments, but these are separate from patient access. “Those areas may have tiers higher than patient access,” notes Woodward. Many employees received a pay increase because of this difference.

All employees had their years of service, experience, and certifications verified to determine which tier they fell into. “Once complete, all employees were moved to their applicable tiers at once,” says Woodward.

Before the tiers were implemented, patient access leaders gave a presentation to each department about updated job descriptions and required criteria.

“Over the course of several days, management met with individuals to update them about their new level and/or pay, with effective dates,” says Woodward. Most employees received a pay increase. “However, if experience, years, and/or education did not allow for any increase, they stayed at Tier 1, and the pay did not change,” says Woodward.

Customer service experience, working at a call center, and medical office duties that include scheduling and knowledge of insurance terms are some of the criteria staff members must meet to be promoted. (See related story on promotions within the revenue cycle in this issue.)

“Medical coding and accounting is a plus for job placement in revenue cycle departments,” adds Woodward. “We have broadened our scope of what is an accepted revenue cycle background.”

Go outside work area

Education doesn’t always mean going to school and earning another degree. April C. Robinson, MBA, MHA, former patient access manager at Palmetto Health Richland in Columbia, SC, says, “It can simply mean staying abreast of the changing culture and the fluid environment that you work in.” She recommends patient access employees do these things to advance:

  • Increase familiarity with systems used by patient access.

Many patient access areas use multiple systems for registration, scheduling, electronic medical records, and billing. “Being educated on how these fragmented systems work with one another gives employees the ability to function from the front end of the revenue cycle to the back end,” says Robinson.

  • Research similar facilities.

“This is a great way to expand your knowledge and learn best practices,” says Robinson. One way an entry-level employee can learn about other facilities is to join a state or local professional group for patient access. Robinson is a member of her state’s National Association of Healthcare Access Management chapter, the South Carolina Association of Healthcare Access Management, which offers annual workshops and conferences.

“These meetings allow time for the participants to get together and discuss current hot topics and common concerns within access service departments,” says Robinson. “It is a great networking opportunity.”

  • Take community college courses in Microsoft Office, public speaking, basic medical terminology, English composition, and general communications.

“These basic classes can help build the foundation that can lead to promising careers,” says Robinson. Some organizations offer tuition reimbursement for such courses. If this reimbursement is not the case, she says, “building an educational foundation for a better future always pays off in the long run.”