Job Summary

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.

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Responsibilities

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

Qualifications

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

* Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children's, unless approved for a medical or religious exemption.

Company Profile

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 14,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org. At Texas Children's Hospital, diversity, equity, and inclusion are at the core of our values and mission for the patients and families that we serve. We are committed to providing a diverse and inclusive work environment for all faculty, staff and learners throughout our organization. We believe that each member of our one amazing team provides enrichment that allows us to create a lasting legacy for future employees of this great organization.

Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.