Patient Access Representative

 
Position: Patient Access Representative

Job ID: 149820

Location: US-TX-The Woodlands

Department: WOO EC ADMISSIONS

Talent Area: Administrative Support

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: Tues – Sat, 6p – 3a (flex)

About Texas Children's Hospital

Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston, opened its doors in April 2017. Located in one of the fastest growing areas in north Houston, the hospital, which has a staff of over 600, has already provided thousands of patients with specialty care closer to home. The outpatient building, which opened in October 2016, includes 72 exam rooms and clinics for major pediatric specialties including cancer, cardiology, allergy/immunology/rheumatology and diabetes/endocrinology. The hospital’s inpatient building features the area’s only dedicated pediatric emergency center with 25 patient rooms, 32 acute care beds, four operating rooms, 12 radiology suites and 28 critical care rooms.   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:

Do you thrive in a fast-paced hospital environment? Then keep reading. 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.

  

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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


Qualifications:

  • High School Diploma or equivalent
  • 6 months 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

 



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