Patient Access Representative II - Pediatrics (TMC)

UTHealth Houston•Houston, TX

19h•Onsite

About The Position

The Patient Access Representative working in our Pediatric TMC clinic is responsible for ensuring medical necessity compliance, verifying eligibility, and posting payments. UT Physicians Pediatrics offers well-child check-ups, immunizations, physicals, and routine care parents expect – all in a caring and state-of-the-art environment. In 2020, the center earned recognition as a Patient-Centered Medical Home (PCMH) by the highly respected National Committee for Quality Assurance (NCQA).

Requirements

High School Diploma or equivalent required
2 years of experience in a hospital or medical business office setting required

Nice To Haves

None

Responsibilities

Obtains demographic, insurance and financial information from patient or guarantor.
Enters information in computer system with a high degree of accuracy.
May schedule patient appointments and enter required information in the computer system in an accurate and timely manner.
Explains all required forms to the patient or guarantor and obtains the necessary signatures.
Ensures medical necessity compliance by obtaining necessary data, reviewing Compliance System, communicating information to patient or guarantor and obtaining necessary signatures.
Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility. Completes complex financial counseling including the review and submission of charity applications.
Identifies alternative resources for financial reimbursement.
Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes.
Posts payments in the computer system and generates the appropriate patient receipts.
Communicates in an effective and professional manner with Physicians, Care Management, ancillary departments, nursing units, physicians' office staff, insurance companies, as well as patients and their families (all Patient Access customers).
Completes thorough and accurate documentation. Adheres to all university policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
Performs other duties as assigned.

Benefits

100% paid medical premiums for our full-time employees
Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year)
The longer you stay, the more vacation you’ll accrue!
Longevity Pay (Monthly payments after two years of service)
Awesome retirement/pension plan
Free financial and legal counseling
Free mental health counseling services
Gym membership discounts and access to wellness programs
Other employee discounts including entertainment, car rentals, cell phones, etc.
Resources for child and elder care