Patient Access Representative

DRISCOLL HEALTH PLAN•Corpus Christi, TX

About The Position

The Patient Access Representative supports service department operations at multiple Driscoll Health System facility locations. Reporting to the Central Patient Access Supervisor, the position handles referral creation and intake, insurance verification, authorization procurement, pre-service patient contact, documentation, and collection of out-of-pocket expenses. It requires attention to detail while supporting multiple specialties and locations, along with age-appropriate communication and safe practices when interacting with customers, patients, and families.

Requirements

High school diploma or GED, or one to three months of related experience and/or training, or an equivalent combination of education and experience.
Attention to detail when handling multiple specialties and facility locations.
Ability to use appropriate age-specific communication and safety practices when interacting with customers, patients, and families.

Responsibilities

Maintain confidentiality and comply with hospital policies, corporate compliance and integrity guidelines, customer service standards, and dress code.
Answer department calls promptly and courteously, listen to customer needs, document telephone encounters, conduct warm transfers, and respond to emails and voicemails according to urgency.
Gather patient demographic and financial information and contact patients or guardians with appointment confirmations, pre-visit instructions, and other pertinent information.
Contact referring providers or guardians to obtain missing information and validate existing information, and facilitate referral intake based on treatment location.
Create patient encounters and enter accurate demographic, financial, and referral information in patient accounting systems and Epic.
Verify insurance benefits, document findings, obtain authorizations as appropriate, and complete pre-service work in Epic work queues according to policies and procedures.
Refer cases for financial screening when indicated and collect, submit, file, and document appropriate records and paperwork.
Review schedules and registrations for duplicate medical record numbers, multiple same-day visits, missing pre-registration items, cancellations, referral data elements, and demographic or financial discrepancies.
Validate insurance eligibility, coverage, and authorizations for anticipated procedures.
Explain insurance benefits as quoted by the insurance carrier, determine and document patient payment responsibility, collect out-of-pocket expenses, and prepare receipts.
Validate patient address and phone number and ensure paperwork is complete and correctly filed or attached to the patient record.
Keep the cash box balanced and ensure payments received are receipted and accounted for.
Perform other reasonably related business duties as assigned.