Patient Access Representative

USPI•San Antonio, TX

About The Position

USPI Foundation Surgical Hospital is seeking a full-time Patient Access Representative. The facility has 25 beds, 8 operating rooms, and 3 emergency rooms, and performs outpatient orthopedic and spine surgical procedures. The Patient Access Representative is responsible for complete and accurate registration of patients receiving services at the facility. The role gathers and enters patient information, verifies benefits for non-pre-registered patients, obtains required signatures, and collects co-payments, deductibles, and co-insurance at the time of service. The representative supports an efficient, complete, and timely registration process that reflects the facility’s customer service philosophy.

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 WPM and complete forms, simple correspondence, payment transactions, and data entry.
Excellent verbal and written communication and interpersonal skills.
Ability to manage multiple tasks with short timelines, prioritize and organize work, and complete assignments accurately and on time.
Ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, coworkers, employers, and insurance representatives.
Pleasant disposition, positive attitude, and ability to maintain a cordial and professional approach during stressful periods.
Skill 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 needed to achieve optimal reimbursement.

Nice To Haves

Working knowledge of governmental regulations and other reimbursement criteria.

Responsibilities

Communicate with clinical departments or the Scheduling Representative to obtain appointments and orders before the service date.
Pre-register 98% of scheduled patients at least three business days before arrival.
Obtain, validate, and accurately enter patient demographic and insurance information, using information from physician offices or patients by direct contact, telephone, or fax.
Review the MPI to help avoid duplicate medical record numbers.
Obtain signatures on forms and documents required by the hospital and law.
Ensure the MSP Questionnaire is completed for every Medicare registration.
Coordinate with physician office staff, schedulers, and hospital departments to prepare required information before patient arrival.
Use online programs to verify insurance eligibility and benefits, document findings, and assist with insurance pre-authorizations and pre-certifications when requested by the Director.
Communicate with physician office staff to resolve authorization issues and coordinate registrations.
Collect applicable co-payments, deductibles, and co-insurance when patients arrive for service.
For Emergency registration, ensure compliance with EMTALA regulations.
Log cash collections, generate receipts, and maintain balanced cash.
Meet monthly cash collection goals established collaboratively by the Department Director/Manager and CBO.
Copy or scan insurance cards and driver licenses.
Use the phone system professionally to handle, transfer, and assist with calls as needed.
Perform front-desk reception and greeting as needed.
For Community Hospital only, verify medical licensure and check Medicare Sanctions websites for non-credentialed physicians ordering outpatient diagnostic tests.
Provide customer service and communication to internal and external contacts, supporting a positive hospital encounter for patients and families.
Meet established individual and team quality and productivity standards.
Adapt positively to changes in policies, procedures, operations, and insurance requirements.
Foster team-based results.
Follow time and attendance standards and provide notice of absences or tardiness within departmental time frames.
Protect patient confidentiality and follow HIPAA guidelines.
Demonstrate required competencies annually through testing or daily quality review and direct observation.
Track and monitor productivity as requested.
Keep the Department Director or Team Lead informed of registration delays.
Maintain current knowledge of scheduling, registration, insurance verification, and related processes to provide coverage for absent team members.
Perform other duties as assigned.