Patient Access Representative Senior - Business Office

CHRISTUS Health; San Antonio (TX); On-site; USD 42,000 - 54,000; Full time

Job summary

CHRISTUS Health in San Antonio, TX seeks a Patient Access Representative Senior to manage financial interactions with patients and third-party payers. The role includes counseling, billing, collections, and ensuring compliance with federal and hospital standards while communicating with patients, families, physicians, and insurers.

Strong attention to detail and customer service are essential. Responsibilities include submitting insurance claims, following up on denials, applying adjustments or

Qualifications

• High School Diploma or equivalent experience preferred.
• 3-5 years of experience preferred.

Responsibilities

• Submits insurance claims to third party payors electronically and on paper; follows up on unpaid claims.
• Evaluates and processes accounts for adjustments, charity, outside assistance or bad debt.
• Collects balances due from patients using calls, statements, letters or third party services.
• Receives, processes and responds to correspondence or phone inquiries from patients, guarantors, insurance companies, attorneys, etc.
• Compiles data, tracks results and reports to management.
• Supports the department in achieving established performance targets.
• Takes responsibility to ensure compliance with policies and regulatory standards.

Education

High School Diploma or equivalent experience

Job description

Summary

The Patient Access Representative Senior performs duties relating to financial aspects of patient care, including financial counseling, billing and collection of accounts. Additionally, the job duties will include ensuring the hospital maintains compliance with Federal regulations, JCAHO, and Department of Health and Hospital compliance standards, along with communicating directly with patients and families, physicians, nurses, insurance companies and third party payers. The Patient Access Representative Senior also handles difficult patient account management issues escalated by other staff, and assists managers with various other duties as necessary.

Responsibilities

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Submits insurance claims to third party payors electronically and on paper. Follows up on unpaid third party claims to resolution (payment or denial).
• Evaluates and processes accounts for adjustments, charity, outside assistance or bad debt. Analyzes accounts to ensure full reimbursement and to satisfy patient and/or insurance company inquiries.
• Collects balances due from patients using phone calls, personal contact, statements, letters or third party services.
• Receives, processes and responds to correspondence or phone inquiries from patients, guarantors, insurance companies, attorneys, etc.
• Compiles data, tracks results and reports to management.
• May be assigned specialty responsibilities in the areas of refunds, reconciliation, balancing and/or posting and in data collection and analysis.
• Handles difficult patient account management issues referred by other staff.
• Supports the department in achieving established performance targets.
• Takes personal responsibility to ensure compliance with all policies, procedures and standards as promulgated by state and federal agencies, the hospital, and other regulatory entities.
• Performs all duties in a manner that protects the confidentiality of patients and does not solicit or disclose any confidential information unless it is necessary in the performance of assigned job duties.
• Assists managers with various duties including, but not limited to, review of write-offs, adjustments, refunds and discounts; coordinating work group activities; and training of other staff.

Job Requirements

Education/Skills

• High School Diploma or equivalent experience preferred

Experience

• 3-5 years of experience preferred

Licenses, Registrations, or Certifications

• None required

Work Schedule

5 Days - 8 Hours

Work Type

Full Time