Patient Access Representative - PT Access Administration - 007

TCH Medical Center; Houston (TX); On-site; USD 36,000 - 48,000; Full time

Job summary

TCH Medical Center in Houston is seeking a Patient Access Representative to ensure timely and accurate patient registration. You will serve as the liaison between patients, payers, medical records, and financial services to maximize hospital reimbursement.

Responsibilities include obtaining and verifying demographic information, checking insurance benefits, and pre-registering patients 2–10 days prior to appointment. The role requires a High School Diploma and related experience.

Qualifications

• HS Diploma required.
• 6 months experience as admissions representative/counselor performing all aspects of the registration process preferred.
• Associate or bachelor’s degree may be substituted for the experience

Responsibilities

• Obtains, verifies, and enters complete and accurate demographic information on all accounts to facilitate smooth processing through the revenue cycle.
• 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.
• Accurately enters complete demographic information into the system. Verified information should include correct spelling of patient name, date of birth, gender, address, phone number, guarantor data, etc.
• Ensures assigned DARs and/or work queues are monitored and worked 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 EPIC. Enters patient estimates in estimating software if required.
• 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.
• Provides estimates of patient liability to patient/guarantor prior to visit as part of financially securing the account. Involves financial counseling department for self pay accounts requiring assistance with funding.
• To provide the highest possible customer service, patients are pre-registered 2-10 working days in advance of appointment/admission.
• Registers unscheduled patients as soon as notified, obtaining insurance benefits and referrals/authorizations prior to providing services or prior to discharge.
• Obtains clinical and financial authorization as required by contract for services.
• For patients who are admitted as inpatient from outpatient areas: verifies inpatient benefits, notifies bed control, and begins the pre-certification process

Skills

Patient registration

Data verification

Customer service

Education

High School Diploma

Associate or Bachelor's degree

Job description

We are searching for a Patient Access Rep. Someone who 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.

Think you've got what it takes?

Qualifications:

• H.S. Diploma required
• 6 months experience as an admissions representative/counselor performing all aspects of the registration process preferred.
• Associate or bachelor’s degree may be substituted for the experience

Responsibilities:

• Obtains, verifies, and enters complete and accurate demographic information on all accounts to facilitate smooth processing through the revenue cycle.
• 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.
• Accurately enters complete demographic information into the system. Verified information should include correct spelling of patient name, date of birth, gender, address, phone number, guarantor data, etc. Patient names should follow hospital protocol regarding middle names, suffixes, etc.
• Ensures assigned DARs and/or work queues are monitored and worked 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 EPIC. Enters patient estimates in estimating software if required.
• 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.
• Provides estimates of patient liability to patient/guarantor prior to visit as part of financially securing the account. Involves financial counseling department for self pay accounts requiring assistance with funding.
• To provide the highest possible customer service, patients are pre-registered 2-10 working days in advance of appointment/admission.
• Registers unscheduled patients as soon as notified, obtaining insurance benefits and referrals/authorizations prior to providing services or prior to discharge.
• Obtains clinical and financial authorization as required by contract for services.
• For patients who are admitted as inpatient from outpatient areas: verifies inpatient benefits, notifies bed control, and begins the pre-certification process