Patient Access Representative

USPI•San Antonio, TX

About The Position

USPI Foundation Surgical Hospital is seeking a motivated PRN Patient Access Representative. The facility has 25 beds, eight operating rooms, and three 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. This includes gathering and entering patient information, verifying benefits for patients who were not preregistered, obtaining required signatures, and collecting copayments, deductibles, and coinsurance at the time of service. The role supports an efficient, complete, and timely registration process consistent with the facility’s customer service philosophy. USPI partners with physicians and healthcare systems to provide ambulatory solutions throughout the United States, delivering surgical services efficiently and with clinical excellence. The organization describes its culture as inclusive, respectful of differences, and supportive of individual contributions and diversity.

Requirements

High school graduate or equivalent required.
Experience in patient registration, verification, and authorization in a medical center or comparable institution.
Ability to type accurately at 40 words per minute, complete forms and simple correspondence, handle payment transactions, and enter data.
Excellent verbal and written communication and interpersonal skills.
Ability to handle 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 necessary to achieve optimal reimbursement.

Nice To Haves

Working knowledge of governmental regulations and other reimbursement criteria preferred.

Responsibilities

Coordinate with clinical departments or scheduling representatives to obtain appointments and orders before the service date.
Preregister at least 98% of scheduled patients a minimum of three business days before arrival.
Obtain, validate, and accurately enter patient demographic and insurance information, including information received from physician offices or patients by direct contact, telephone, or fax.
Review the MPI thoroughly to avoid duplicate medical record numbers.
Obtain signatures on forms and documents required by the hospital and by law.
Ensure the MSP Questionnaire is completed for every Medicare registration.
Work with physician office staff, schedulers, and hospital departments to prepare required information before patient arrival.
Use online programs to verify insurance eligibility and benefits, and document findings on patient accounts.
Assist with contacting insurers for required pre-authorizations and pre-certifications when requested by the Director; communicate with physician office staff to resolve authorization issues and coordinate registrations.
Collect identified copayments, deductibles, or coinsurance when patients arrive for service.
For emergency registration, ensure compliance with EMTALA regulations for all patients.
Log cash collected, generate receipts, and maintain balanced cash at all times.
Meet monthly cash collection goals established collaboratively by the Department Director/Manager and CBO.
Copy or scan insurance cards and driver licenses.
Professionally handle incoming and internal phone calls, transfer calls appropriately, and assist with calls as requested by the Department Director or Team Lead.
Perform front-desk reception and greeting duties as needed.
For Community Hospital only, verify medical licensure and check Medicare Sanctions websites for non-credentialed physicians ordering outpatient diagnostic tests.
Provide premier customer service and communication to internal and external contacts, supporting a positive experience for patients and their families.
Meet established individual and team quality and productivity standards.
Adapt positively to changes in hospital policies, procedures, operations, and insurance requirements; foster team-based results.
Follow time and attendance standards and provide absence or tardiness notification within departmental time frames.
Protect patient confidentiality in accordance with HIPAA guidelines.
Demonstrate required competencies annually through testing, quality review, or direct observation.
Track and monitor productivity as requested, and keep the Department Director or Team Lead informed of registration delays.
Remain current on scheduling, registration, insurance verification, and other registration processes to provide coverage for absent team members.
Perform other duties as assigned.