About Texas Children's Hospital
Do you thrive in a fast-paced hospital environment? We are looking for a Patient Access Representative who can serve as a liaison between patient/family, payers, Healthcare Information Management, Patient Financial Services, and other health care team members. You’ll be asked to facilitate patient tracking and billing by obtaining/verifying accurate and complete demographic information, financially securing, and collecting out-of-pocket responsibility from guarantors to maximize hospital reimbursement.
Does this job sound like you?
Job Duties & Responsibilities
• Maintain compliance with EMTALA, JCAHO, and all other hospital and government regulations applicable to the Admissions settings.
• Identify non-resource patients for possible eligibility for government resources and/or the Hospital’s charity program and refer these patients to a financial counselor
• Obtain, verify, and enter complete and accurate demographic information on all accounts to facilitate smooth processing through the revenue cycle
• Correctly follows the MPI process when changing clinically sensitive data (patient name, date of birth and gender) after a patient has been admitted
• Ensures all work queues are monitored and cleared on a daily basis, ensuring that all elements of the accounts are secured for billing.
• Financially secures all patient accounts to maximize hospital reimbursement in a customer service oriented fashion
• Verifies insurance benefits for all plans associated with patient, confirming the correct payor and plan is entered into the patient accounting system
• Obtains insurance referrals and/or authorizations as required by individual insurance plans, documenting authorization/referral numbers in the appropriate fields for accurate billing
• To provide the highest possible customer service, patients are pre-registered 2-10 working days in advance of appointment/admission
• Maximizes the efficiency and accuracy of the collection process by pursuing collections at the time of service
• Contacts patient/guarantor prior to date of service to inform them of estimated payment due at the time of service. Documents details of all successful and unsuccessful attempts at patient/guarantor contact
• Compares copay information on insurance card to account notes for accuracy
• Collects patient liability at time of service, documenting amount and method collected
• Provides complete and accurate documentation on each visit to ensure compliance with hospital and government regulations
• Maintains accurate statistics on own productivity as part of departmental tracking and quality improvement
• Provides excellent customer service at all times by effectively meeting customer needs, understanding who the customers are, and building quality relationships
• High School Diploma or GED
• 6 months experience as an admission representative/counselor performing all aspects of the registration process highly preferred
• An Associate’s or Bachelor’s degree may be substituted for the preferred experience
• Knowledge of patient access services and the overall effect on the revenue cycle
• A thorough understanding of various insurance plans, payor networks, government resources, and medical terminology
• Ability to demonstrate self-initiated work behaviors, problem solve, interact with a variety of people while always displaying professional courtesy, excellent interpersonal and communication skills, and attention to detail
• Ability to use a networked computer that facilitates access to the Hospital’s patient accounting system and other query software for verification of insurance benefits – all while maintaining patient confidentiality
• Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s, unless approved for a medical or religious exemption.