Patient Access Representative - Mobile

Texas Children's Hospital•Houston, TX

15d

About The Position

The Patient Access Representative ensures timely and accurate patient registration and serves as a liaison among patients and families, payers, Healthcare Information Management (Medical Records), Patient Financial Services, and other healthcare team members. The role uses a unique medical record number to support patient tracking and billing by obtaining and verifying complete demographic information, financially securing accounts, and collecting out-of-pocket responsibility from guarantors to maximize hospital reimbursement. The representative maintains compliance with EMTALA, The Joint Commission, and other applicable hospital and government regulations. The role also identifies patients who may qualify for government resources or the hospital charity program and refers them to a financial counselor. Patient registration work includes verifying insurance benefits and authorizations, providing liability estimates, and supporting billing and revenue-cycle processes.

Requirements

High school diploma required.
Six months of experience as an admissions representative or counselor performing all aspects of the registration process preferred; an associate or bachelor's degree may substitute for this experience.

Nice To Haves

Six months of experience as an admissions representative or counselor performing all aspects of the registration process.

Responsibilities

Obtain, verify, and enter complete and accurate demographic information on patient accounts to support revenue-cycle processing.
Search the patient accounting system for an existing medical record at each visit, using appropriate techniques to prevent duplicate records in the master patient index.
Enter verified demographic details accurately, including patient name, date of birth, gender, address, phone number, and guarantor information, following hospital protocols for names.
Monitor and work assigned DARs and/or work queues daily, ensuring account elements are secured for billing.
Financially secure patient accounts to maximize hospital reimbursement while providing customer service.
Verify insurance benefits for all plans, confirm the correct payer and plan are entered into EPIC, and enter patient estimates in estimating software when required.
Obtain insurance referrals required by individual plans and document referral numbers in the appropriate fields.
Document whether authorization is required and involve the Authorization Specialist when clinical authorizations are needed.
Provide patient liability estimates to patients or guarantors before visits and involve financial counseling for self-pay accounts requiring funding assistance.
Pre-register patients 2–10 working days before appointments or admissions.
Register unscheduled patients promptly after notification and obtain insurance benefits and referrals or authorizations before services or discharge.
Obtain clinical and financial authorization as required by contract for services.
For patients admitted as inpatients from outpatient areas, verify inpatient benefits, notify bed control, and begin the pre-certification process.
Maintain compliance with EMTALA, The Joint Commission, and other applicable hospital and government regulations.
Identify patients who may qualify for government resources or the hospital charity program and refer them to a financial counselor.