Patient Access Representative

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

Requirements
•    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
 

About Texas Children’s