Patient Access Representative III - Wound Care Clinic

Memorial Hermann Health System•Sugar Land, TX

About The Position

The Patient Access Representative III works in the Wound Care Clinic and is responsible for mentoring employees as a team leader, scheduling patient appointments, ensuring medical necessity compliance, verifying eligibility, and posting payments. The role also supports patient financial counseling, account issue resolution, quality review, and effective communication with patients, families, and healthcare and insurance partners. This position works an 8-hour shift Monday through Friday, between 8:00 a.m. and 5:30 p.m.

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 accurately and promptly in the computer system.
Obtain demographic, insurance, and financial information from patients or guarantors and enter it accurately in the computer system.
Explain required forms to patients or guarantors and obtain necessary signatures.
Ensure medical necessity compliance by obtaining required data, reviewing the Compliance System, communicating information, and obtaining necessary 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.
Act as a team leader 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 organizational policies, procedures, standards, and budgetary specifications, 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’s service standards by creating safe, caring, personalized, and efficient experiences for patients and colleagues.
Perform other duties as assigned.