Patient Access Representative

USPI•Houston, TX

39d

About The Position

USPI Memorial Hermann Surgery Center Main Street is seeking a PRN Patient Access Representative. The center has five operating rooms and two treatment rooms and performs outpatient procedures in bariatrics, gastroenterology, general surgery, gynecology, ophthalmology, pain management, spine, urology, ENT, and orthopedics. The position requires weekday availability, with no holidays, weekends, or call. Some early mornings and later evenings may be required, and the schedule may change based on the surgical schedule and daily workflow. The representative supports patient access and registration by preparing registrations before arrival, accurately collecting and entering demographic and insurance information, validating coverage and authorizations, collecting payments, and ensuring required forms and documentation are complete. The role works closely with patients, families, physician offices, schedulers, insurance representatives, and hospital departments while providing professional service and protecting patient confidentiality.

Requirements

High school graduate or equivalent.
Experience in patient registration, verification, and authorization in a medical center or comparable institution.
Ability to type accurately at 40 words per minute, complete forms and simple correspondence, handle payment transactions, and enter data.
Excellent verbal and written communication and interpersonal skills.
Ability to handle multiple tasks with short timelines, prioritize and organize work, and complete assignments accurately and on time.
Ability to communicate effectively, tactfully, and diplomatically with patients, families, medical staff, coworkers, employers, and insurance company representatives.
Pleasant disposition, positive attitude, and ability to remain cordial and professional during stressful periods.
Skill in using office equipment, including basic computer equipment, photocopier, telephone, fax machine, and calculator.
Ability to think and act decisively in a timely manner.
Ability to maintain operational knowledge of insurance requirements necessary to achieve optimal reimbursement.

Nice To Haves

Working knowledge of governmental regulations and other reimbursement criteria.

Responsibilities

Communicate with clinical departments or scheduling representatives to obtain scheduled appointments and orders before the service date.
Pre-register at least 98% of scheduled patients at least three business days before arrival.
Obtain, validate, and accurately enter patient demographic and insurance information, maintaining an accuracy rate above 95%; information may come from physician offices or patients by direct contact, telephone, or fax.
Review the MPI thoroughly to avoid duplicate medical record numbers.
Obtain signatures on all forms and documents required by the hospital and by law.
Ensure the MSP Questionnaire is completed for every Medicare registration.
Work cooperatively with physician office staff, schedulers, and hospital departments to schedule and prepare required information before patient arrival.
Use online programs to verify insurance eligibility and benefits and document findings on patient accounts.
Assist with contacting insurance companies for required pre-authorizations and pre-certifications when asked by the Director.
Communicate with physician office staff to resolve authorization issues and coordinate registrations.
Collect applicable copayments, deductibles, or coinsurance when patients arrive for service.
When working in Emergency registration, ensure compliance with EMTALA regulations for all patients.
Log cash collected, generate receipts, and maintain balanced cash at all times.
Meet monthly cash collection goals determined collaboratively by the Department Director/Manager and CBO.
Obtain and copy or scan insurance cards and driver licenses.
Know how to operate the phone system, professionally handle incoming calls, transfer calls appropriately, and assist with internal calls when requested by the Department Director or Team Lead.
Perform reception and greeter duties at the front desk as needed.
At Community Hospital locations, verify medical licensure and check Medicare Sanctions websites for non-credentialed physicians ordering outpatient diagnostic tests.
Demonstrate excellent customer service and communication with internal and external contacts, supporting a positive experience for patients and their families.
Meet established quality and productivity standards for oneself and the team.
Adapt positively to changes in hospital policy, operations, procedures, and insurance requirements.
Foster and reinforce team-based results.
Follow time and attendance standards and provide timely notice of absences or tardiness according to departmental requirements.
Protect patient confidentiality in accordance with HIPAA guidelines.
Demonstrate required competencies annually through testing, quality review, or direct observation by the Team Lead and Department Director/Manager.
Track and monitor productivity as requested.
Keep the Department Director or Team Lead informed of delays in registration.
Stay current on scheduling, registration, insurance verification, and other registration processes to cover for absent team members.
Perform other duties as assigned.