Patient Access Representative

 
Position: Patient Access Representative

Job ID: 148715

Location: US-TX-Houston

Department: PFW PATIENT ACCESS

Talent Area: Administrative Support

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 11p - 7:30a

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.   Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital opening in 2017. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.   To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Summary:

We are searching for a Patient Access Representative — someone who works well in a fast-paced setting. In this position, you'll serve as a liaison between patient/family, payers, Healthcare Information Management, Patient Financial Services, and other health care team members.

Think you’ve got what it takes?



Responsibilities :

  • Maintains compliance with EMTALA, JCAHO, and all other hospital and government regulations applicable to the Admissions settings
  • Identifies non-resource patients for possible eligibility for government resources and/or the hospital’s charity program and refer these patients to a financial counselor
  • Obtains, verify, and enter complete and accurate demographic information on all accounts to facilitate smooth processing through the revenue cycle
  • 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
  • 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


Qualifications:

  • High school diploma or GED
  • Six (6) months experience as an admission representative/counselor performing all aspects of the registration process
  • Associate’s or bachelor’s degree may be substituted for experience
  • Knowledge of patient access services and the overall effect on the revenue cycle
  • 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
  • Previous experience with patient registration preferred


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