Patient Access Representative II/III - Pediatric Surgery, McGovern Medical School

UTHealth Houston•Houston, TX

About The Position

The Patient Access Representative for Pediatric Surgery supports patient registration and financial clearance for pediatric surgical services. Responsibilities include verifying patient demographics, insurance eligibility, benefits, and authorizations; ensuring medical necessity compliance; collecting payments; and maintaining accurate documentation. The representative collaborates with patients’ families, physicians’ offices, and insurance providers to facilitate timely access to care and provide excellent customer service. Employees must permanently reside and work in the State of Texas. This is a security-sensitive position. The role requires a high school diploma or equivalent and at least two years of experience in a hospital or medical business office setting.

Requirements

High school diploma or equivalent.
At least two years of experience in a hospital or medical business office setting.
Must permanently reside and work in Texas.
Ability to exert up to 50 pounds of force occasionally, up to 20 pounds frequently, and/or up to 10 pounds constantly to move objects.
Ability to maintain the security or integrity of critical infrastructure, where applicable.

Responsibilities

Obtain demographic, insurance, and financial information from patients or guarantors.
Enter information into the computer system accurately.
Schedule patient appointments as needed and enter required information accurately and on time.
Explain required forms to patients or guarantors and obtain necessary signatures.
Ensure medical necessity compliance by obtaining necessary data, reviewing the Compliance System, communicating information to patients or guarantors, and obtaining necessary signatures.
Protect the facility’s financial integrity by collecting patient liability, establishing payment arrangements, discussing payment options, screening for eligibility, and completing complex financial counseling, including reviewing and submitting charity applications.
Identify alternative resources for financial reimbursement.
Verify insurance eligibility and benefits, and ensure notifications and authorizations are completed within required timeframes.
Post payments in the computer system and generate appropriate patient receipts.
Communicate professionally and effectively with physicians, Care Management, ancillary departments, nursing units, physicians’ office staff, insurance companies, patients, and families.
Complete thorough and accurate documentation and adhere to university policies, procedures, standards, and budgetary specifications, including time management, supply management, productivity, and accuracy of practice.
Promote professional growth by meeting mandatory and continuing education and skills competency requirements; support department goals and serve as a preceptor, mentor, and resource to less experienced staff.
Perform other duties as assigned.

Benefits

100% paid medical premiums for full-time employees.
Generous time off, including holidays, a preventative leave day, vacation, and sick time (approximately 37–38 days per year).
Vacation accrual increases with length of service.
Longevity pay in monthly payments after two years of service.
Retirement/pension plan.
Free financial and legal counseling.
Free mental health counseling services.
Gym membership discounts and access to wellness programs.
Employee discounts, including entertainment, car rentals, and cell phones.
Resources for child and elder care.