About Texas Children's Hospital
Scheduled to open in 2017, Texas Children’s Hospital The Woodlands is a 548,000-square-foot, state-of-the-art free-standing pediatric hospital designed, equipped and staffed exclusively to treat children and adolescents in The Woodlands and counties throughout Greater North Houston such as Montgomery, Walker, Grimes, Liberty, Harris, Polk, San Jacinto and Hardin counties. Our new facility will include 25 emergency center rooms, 32 acute rooms, 28 critical care rooms, 12 radiology rooms and 4 operating rooms. We will also offer inpatient and outpatient pediatric care in more than 25 specialties including: cancer, cardiology, neurology, orthopedics, diabetes and endocrinology, urology, sports medicine, gastroenterology and nutrition, pediatric surgery, plastic surgery, otolaryngology, allergy and immunology, dermatology, adolescent medicine and physical rehabilitation. Outpatient care areas are scheduled to open in fall 2016.
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We are searching for a Patient Access Representative - someone who works well in a fast-paced hospital 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. 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.
Think you’ve got what it takes?
- 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 equivalent
- 6 months of experience as an admission representative/counselor performing all aspects of the registration process*
- An Associate’s or Bachelor’s degree may be substituted for the 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
- Previous experience with patient registration preferred
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