Patient Access Representative - West Campus

 
Position: Patient Access Representative - West Campus

Job ID: 143212

Location: US-TX-Houston

Department: WC MAIN ADMISSIONS

Talent Area: Administrative Support

Full/Part Time: Part-Time

Regular/Temporary: Regular

Shift: 8am-5pm

About Texas Children's Hospital

Texas Children’s Hospital West Campus is Houston’s first community hospital designed, built and equipped exclusively for children in one of the city’s most rapidly growing communities in the area from Sugar Land to Bryan-College Station, Texas. Located at I-10 and Barker Cypress, our 515,007-square-foot hospital houses the only 24/7 pediatric emergency room in the Greater West Houston area, four operating rooms, 16-bed pediatric intensive care unit, 46 acute care beds, advanced imaging services including MRI and CT scans, a neurophysiology sleep lab, a pathology lab and a full-scale pharmacy.   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 will ensure timely and accurate patient registration by serving as the liaison between patient/family, payers, Healthcare Information Management (Medical Records), Patient Financial Services (PFS or Business Services) and other health care team members. While utilizing a unique medical record number, the Patient Access Representative will 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. Maintain compliance with EMTALA, The Joint Commission, and all other hospital and government regulations applicable to the Admissions setting. 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.

 

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Responsibilities :

  • Thoroughly searches the patient accounting system for an existing medical record on each visit. Uses appropriate search techniques to ensure that no duplicate medical records are created in the master patient index
  • Ensures assigned DARs and/or work queues are monitored and worked on daily, ensuring that all elements of the accounts are secured for billing
  • Verifies insurance benefits for all plans associated with patient, confirming the correct payor and plan is entered into EPIC
  • Obtains insurance referrals, as required by individual insurance plans, documenting referral numbers in the appropriate fields for accurate billing
  • Documents whether authorization is required and involves Authorization Specialist when needed for clinical authorizations
  • To provide the highest possible customer service, patients are pre-registered 2-10 working days in advance of appointment/admission
  • Obtains clinical and financial authorization as required by contract for services or patients who are admitted as inpatient from outpatient areas: verifies inpatient benefits, notifies bed control, and begins the pre-certification process
  • Provides clear notes on breakdown of patient liability in patient accounting system, explaining deductible, coinsurance, and copay amounts
  • Involves Financial Counselor when needed to assist uninsured and underinsured patients/guarantors for government, third party insurance, and/or charity benefits eligibility and obtains appropriate coverage as measured by medical record review and Patient Financial Services follow up reports


 

 

 



Qualifications:

 

  • High school diploma or equivalent
  • Six (6) months of experience as an admissions representative/counselor performing all aspects of the registration process (an Associate’s or Bachelor’s degree may be substituted for the experience
  • 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
  • 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 are essential to this position
  • *Bilingual english/spanish preferred


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