Patient Access Representative

Hospital Management Company•Cedar Park, TX

12d

About The Position

The Patient Access Representative is responsible for patient registration, admissions, information collection and validation, and requisitioning orders and services. The role handles insurance verification, co-payment collection, and related paperwork, as well as administrative functions such as scheduling, answering phones, and coordinating general requests. The position supports patients’ access to care by providing timely, courteous assistance and resolving non-clinical questions within the scope of knowledge. It also performs documentation and medical-record audits, obtains insurance authorizations as needed, helps patients understand pre- and post-exam requirements, and maintains organized patient records. The representative is expected to follow hospital and departmental policies, protect patient confidentiality, comply with applicable laws and standards, and represent the organization professionally.

Requirements

High school diploma or GED required.
BLS certification required.
Excellent oral and written communication and interpersonal skills.
Problem-solving abilities.
Professional and positive demeanor.
Proficiency in Microsoft Office and data-entry systems.
Accuracy and attention to detail.
Ability to maintain patient and employee confidentiality and comply with applicable policies, laws, and standards.

Nice To Haves

Associate degree or higher preferred.
CHAA or CHAM certification preferred.
One year of experience in an acute patient care setting preferred.

Responsibilities

Register patients and complete registration functions, including explaining and obtaining consents and authorizations and collecting financial paperwork and co-payments.
Respond promptly and courteously to phone calls and other incoming communications, answer inquiries, and follow up with the appropriate party when needed.
Resolve non-clinical questions within the scope of knowledge and provide customer service by phone and in person.
Audit documentation for medical necessity, plans of care, and payer requirements, including Medicare requirements, using computer-based systems.
Schedule outpatient clinic and procedure appointments as needed.
Obtain prior health insurance authorization for outpatient procedures and inpatient stays as needed.
Educate patients about pre-exam and, when necessary, post-exam requirements within the role’s scope.
Prepare and distribute patient reminders, results, and recall letters.
Establish and maintain files, and scan medical records in an organized and timely manner.
Audit medical records for quantitative and qualitative accuracy.
Manage, direct, and respond to incoming office correspondence, including mail, email, faxes, and telephone calls, and forward queries to appropriate staff.
Attend departmental staff meetings and provide feedback.
Model the principles of Family Hospital Management and organizational values.
Comply with applicable HIPAA, EMTLA, and Joint Commission requirements and provide required literature to patients.
Perform other duties assigned at the departmental or organizational level.
Follow dress, identification, attendance, training, confidentiality, professional conduct, health and safety, security, hazardous materials, and organizational compliance requirements.
Identify patient confidentiality issues and report them to appropriate hospital personnel.