Patient Access Representative

3M HEALTHCARE; Corpus Christi (TX); On-site; USD 42,000 - 54,000; Full time

Job summary

Driscoll Health System seeks a Patient Access Support role to aid referrals, verify insurance, obtain authorizations, and contact patients regarding pre-service information and out‑of‑pocket details. Accurate documentation and confidentiality are essential as you support multiple hospital locations and CPSST offices.

Primary duties include pre‑registration data capture, insurance verification, and coordinating with guardians and providers to ensure smooth patient flow and billing alignment.

Qualifications

• Requires a high school diploma or GED.
• Minimal related experience or training (1–3 months) may be acceptable.
• Customer service skills and ability to handle sensitive information are required.

Responsibilities

• Handle incoming calls and emails with courtesy and accuracy.
• Verify patient information and insurance details, and document actions in systems.
• Assist with pre-visit instructions and scheduling communications.

Education

High school diploma or GED

Job description

Job Summary

This position reports to the Central Patient Access Supervisor and supports the service department functions at multiple Driscoll Children’s Hospital locations and CPSST offices. Responsibilities include referral creation, insurance verification, authorization procurement, pre-service patient contact, and documentation of actions taken to collect out‑of‑pocket expenses. Attention to detail, patient confidentiality, and adherence to hospital policies are essential.

Essential Duties and Responsibilities

Customer Service Duties

• Answer department telephone immediately or within three rings using courtesy and patience.
• Listen to customer needs and take appropriate action.
• Respond to urgent emails and voicemails promptly and to non‑urgent ones at the end of the day.
• Gather patient demographic and financial information in a kind and courteous manner.
• Document telephone encounters.
• Call patients to confirm appointment times and provide information such as out‑of‑pocket expense, education, directions, parking information, etc.
• Conduct warm transfers as needed.
• Place outbound calls to referring providers or guardians to obtain missing and validate existing information based on treatment location.
• Facilitate referral intake based on treatment location.
• Attempt to reach patient guardians to communicate any pre‑visit instructions.
• Complete any additional ancillary tasks.

Patient Accounting Duties

• Accurately create patient encounter in patient accounting systems using appropriate search criteria and interview method.
• Verify patient’s insurance benefits and document findings within the required timeframe.
• Refer cases for financial screening as indicated.
• Complete all authorization procurement work functions.
• Accurately collect and enter patient demographics into patient accounting systems.
• Populate referral data elements into Epic Referral Record.
• Complete all pre‑service work functions in Epic work queues according to defined policies and procedures.
• Complete documentation in Epic per Driscoll Health System and departmental guidelines.
• Collect, submit, and file documents as appropriate.

Quality Assurance Duties

• Review schedule/pre‑registrations/registrations to identify potential duplicate medical record numbers.
• Update data discrepancies in Epic.
• Identify patients with multiple same‑day visits to match demographic and insurance data for each pre‑registration.
• Review patient demographic and financial data to ensure accuracy.
• Validate insurance eligibility and coverage for anticipated procedures.
• Confirm that insurance authorizations have been obtained from referring physicians and payors when necessary.
• Review pre‑registration list for cancellations and notify department as indicated.
• Identify patients missing any pre‑registration items.
• Check for referral minimum data set elements.

Patient Financial Duties

• Review documented notes for payment requirements; explain insurance benefits as quoted by the carrier and collect patient’s out‑of‑pocket expenses.
• Determine if the patient is responsible for payment of service and document how payment is calculated and received.
• Refer cases for financial screening as indicated.
• Prepare hospital receipt for payment received.
• Validate address and phone number.
• Ensure all paperwork is complete and documents are correctly filed or attached to patient record.

Cashiering Duties

• Maintain cash box in balance at all times.
• Receive payments, receipting and accounting them at all times.

Education and Experience

• High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.