Patient Access Representative Senior - Patient Access Center

CHRISTUS Health; Tyler (TX); On-site; USD 42,000 - 56,000; Full time

Job summary

CHRISTUS Health is seeking a Patient Access Representative Senior in Tyler, TX to manage financial aspects of patient care, including counseling, billing, and collections. The role ensures compliance with federal regulations, JCAHO standards, and hospital policies while communicating with patients, families, physicians, and insurers.

Responsibilities include submitting insurance claims, following up on denials, evaluating accounts for adjustments, and maintaining accurate data for management

Qualifications

• 3-5 years of experience in patient access or medical billing preferred.
• Experience with insurance claims processing and billing cycles is beneficial.
• Excellent communication and interpersonal skills are required.

Responsibilities

• Meets expected competencies and professional standards.
• Submits insurance claims to third party payors electronically and on paper.
• Follows up on unpaid claims to resolution.
• Collects balances due from patients via calls, statements, and correspondence.
• Responds to inquiries from patients, guarantors, insurers, and attorneys.
• Compiles data, tracks results, and reports to management.
• Supports special duties in refunds, balancing, posting, and data analysis.
• Maintains compliance with policies, procedures and regulations.

Skills

Financial counseling

Medical billing

Customer service

Communication

Education

High School Diploma or equivalent

Tools

None

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:

MULTIPLE SHIFTS AVAILABLE

Work Type:

Full Time