Patient Access Representative - Patient Access Center

CHRISTUS Health•Tyler, TX

About The Position

Patient Access Representatives facilitate a welcoming and easy-access experience and establish encounters for patients who meet the guidelines for hospital service. They ensure accurate entry of demographic, financial, guarantor, and encounter-related information; verify insurance eligibility; obtain service authorizations; and collect estimated patient portions and prior balances. They also assess patients for appropriate financial assistance and obtain required hospital-document signatures. The role supports successful financial outcomes for patient services and helps the hospital maintain compliance with federal regulations, JCAHO, and Department of Health and hospital standards. Patient Access Representatives communicate with patients and families, physicians, nurses, insurance companies, and third-party payers. The position requires a professional manner, effective communication and organizational skills, dependability, flexibility, and teamwork. Representatives support changing departmental and hospital needs, including assisting during disasters, shifting assignments or work areas as needed, coordinating workflow as volumes fluctuate, completing required training, and contributing to performance targets and team process improvements. They must protect patient confidentiality, follow applicable policies and regulatory standards, and adapt services to the physical, psychosocial, cultural, age-specific, and developmental needs of the people served.

Requirements

High school diploma or equivalent experience preferred.
1–3 years of experience preferred.
No licenses, registrations, or certifications required.
Professional appearance and behavior, good communication skills, effective organizational skills, dependability, flexibility, and teamwork.

Responsibilities

Accurately enter required scheduling and registration information, including patient demographic, financial, and guarantor information and encounter-related notes.
Verify insurance eligibility and obtain necessary authorizations for services.
Calculate and collect estimated patient portions based on benefits and contract reimbursement, as well as prior balances.
Perform financial assessments for appropriate assistance programs.
Explain hospital documents and obtain required signatures from patients or legal guardians.
Represent the Patient Access department professionally and courteously.
Assist the hospital in the event of an internal or external disaster.
Support changing departmental needs and patient volumes, including assignment to other areas and shift changes as needed.
Support the department in achieving established performance targets and complete required training.
Follow established standard processes and contribute to maintaining an efficient, clean, and orderly workplace using 5S principles and practices once implemented in the work unit.
Coordinate and communicate workflow and work tasks to manage fluctuating volumes.
Provide feedback to help identify educational and mediation needs by reporting issues, problems, and opportunities (IPOs).
Perform assigned responsibilities in a manner that meets the population-specific and developmental needs of those served, adapting service methods as appropriate.
Follow policies, procedures, and standards established by state and federal agencies, the hospital, and other regulatory entities.
Protect patient confidentiality and disclose confidential information only as necessary to perform assigned duties.
Perform other duties as assigned.