Patient Access Representative

DRISCOLL HEALTH PLAN•Corpus Christi, TX

About The Position

The Patient Access Representative supports service department functions at multiple Driscoll Health System facilities and specialties. Responsibilities include referral creation and intake, insurance verification, authorization procurement, pre-service patient contact, and documentation of efforts to collect out-of-pocket expenses. The role requires age-appropriate communication and safe practices when interacting with customers, patients, and families, along with careful attention to detail while working across multiple locations. The position also provides customer service, completes patient accounting and pre-registration tasks in Epic and other patient accounting systems, reviews records for accuracy and completeness, explains insurance benefits and collects patient payments, and performs cashiering duties. The position reports to the Central Patient Access Supervisor.

Requirements

High school diploma or general education degree (GED), or one to three months of related experience and/or training, or an equivalent combination of education and experience.
Ability to perform the essential duties satisfactorily, including accurate handling of patient, insurance, referral, and payment information.
Ability to communicate appropriately with customers, patients, and families, including age-specific communication and safety practices.

Responsibilities

Maintain confidentiality and comply with hospital policies, procedures, customer service standards, dress code, and corporate compliance and integrity guidelines.
Answer department telephone calls promptly and courteously; listen to customer needs and take appropriate action.
Respond promptly to urgent emails and voicemails and address non-urgent messages by the end of the day.
Gather patient demographic and financial information, document telephone encounters, confirm appointment times, and communicate relevant information such as out-of-pocket expenses, education, directions, and parking.
Conduct warm transfers as needed and place outbound calls to referring providers or guardians to obtain missing information or validate existing information.
Facilitate referral intake and communicate pre-visit instructions to patient guardians as necessary.
Create patient encounters and accurately enter patient demographic and referral data in patient accounting systems and Epic.
Verify insurance benefits, document findings, refer cases for financial screening as indicated, and obtain authorizations as required.
Complete pre-service work in Epic work queues and document actions according to Driscoll Health System and department guidelines.
Collect, submit, file, and attach documents as appropriate.
Review schedules and pre-registration and registration records for duplicate medical record numbers, discrepancies, missing items, and multiple same-day visits; update data as needed.
Validate insurance eligibility, coverage, and required authorizations, and check referral records for minimum data set elements.
Review cancellations and notify the department as indicated.
Explain insurance benefits as quoted by the carrier, determine and document patient payment responsibility, and collect out-of-pocket expenses.
Prepare hospital receipts, validate patient addresses and phone numbers, and ensure paperwork is complete and correctly filed.
Keep the cash box balanced and ensure payments are receipted and accounted for.
Perform other reasonably related business duties assigned by the immediate supervisor or hospital administration.