Patient Access Representative III

Memorial Hermann Health System•Cape Girardeau, MO

About The Position

The Patient Access Representative III is responsible for mentoring employees as a team leader and supporting patient access operations. Duties include scheduling appointments, gathering and accurately entering patient demographic, insurance, and financial information, ensuring medical necessity compliance, verifying insurance eligibility and benefits, completing required notifications and authorizations, and posting payments. The role also supports financial counseling and patient account resolution, conducts quality reviews, and helps identify process improvements. The representative contributes to daily team operations by scheduling employees, answering employee questions, and assisting with orientation and training. The position communicates professionally with patients and families, physicians and their offices, care management, ancillary departments, nursing units, and insurance companies. It also requires adherence to organizational policies and standards, a commitment to safe and compassionate service, and support for staff development and departmental goals.

Requirements

Three years of experience in a hospital or medical business office setting.
Ability to multitask.
Proficient typing and keyboarding skills.

Nice To Haves

High school diploma or GED preferred.
Supervisory and/or leadership experience preferred.

Responsibilities

Schedule patient appointments and enter required information into the computer system accurately and in a timely manner.
Obtain demographic, insurance, and financial information from patients or guarantors and enter it accurately into the computer system.
Explain required forms to patients or guarantors and obtain necessary signatures.
Ensure medical necessity compliance by obtaining necessary data, reviewing the Compliance System, communicating information to patients or guarantors, and obtaining signatures.
Collect patient liability, establish payment arrangements, discuss payment options, screen for eligibility, complete complex financial counseling, review and submit charity applications, and identify alternative reimbursement resources.
Verify insurance eligibility and benefits and ensure notifications and authorizations are completed within required timeframes.
Post payments in the computer system and generate appropriate patient receipts.
Monitor, review, and resolve patient account issues on assigned reports; perform account analysis and trending.
Complete quality reviews and monitor for process improvement opportunities.
Lead departmental work by ensuring daily processes are complete, scheduling employees, answering employee questions, and assisting with employee orientation and training.
Communicate effectively and professionally with physicians, care management, ancillary departments, nursing units, physicians’ office staff, insurance companies, patients, and families; complete thorough and accurate documentation.
Ensure safe care for patients, staff, and visitors and adhere to Memorial Hermann policies, procedures, and standards, including time management, supply management, productivity, and service quality.
Meet mandatory and continuing education and skills competency requirements; support department goals and serve as a preceptor, mentor, and resource to less experienced staff.
Model Memorial Hermann service standards by creating compassionate, personalized, safe, caring, and efficient experiences for patients and colleagues.
Perform other duties as assigned.