Sr Patient Access Representative - Pediatrics (Bay Area)

UTHealth Houston•Houston, TX

2d•Onsite

About The Position

The Sr. Patient Access Representative supports primary and specialty pediatric care at the Pediatric Bay Area Clinic by handling patient access needs, including referrals, insurance verification, authorizations, and patient account concerns. This in-person role works with patients, families, providers, and payers to resolve referral and coverage issues, maintain accurate documentation, and support efficient clinic workflows. The position is Monday through Friday, 8 a.m. to 5 p.m. The role is responsible for mentoring employees as a team leader, scheduling patient appointments, ensuring medical necessity compliance, verifying eligibility, and posting payments. It also involves complex financial counseling, account review, quality monitoring, and support for employee orientation and training. Employees must permanently reside and work in Texas. This is a security-sensitive position.

Requirements

High school diploma or equivalent.
Four years of experience in a hospital or medical business office setting.
Ability to multitask.
Proficient typing and keyboarding skills.
Must permanently reside and work in Texas.
Ability to meet the security requirements for this security-sensitive position.

Responsibilities

Schedule patient appointments and accurately enter required information into the computer system.
Obtain demographic, insurance, and financial information from patients or guarantors and enter it accurately.
Explain required forms and obtain necessary signatures.
Ensure medical necessity compliance by obtaining required data, reviewing the Compliance System, communicating information, and obtaining signatures.
Collect patient liability, establish payment arrangements, explain payment options, screen for eligibility, complete complex financial counseling, review and submit charity applications, and identify alternative reimbursement resources.
Verify insurance eligibility and benefits, and ensure notifications and authorizations are completed within required timeframes.
Post payments in the computer system and generate patient receipts.
Monitor, review, and resolve patient account issues on assigned reports; perform account analysis and trending.
Complete quality reviews and identify process improvement opportunities.
Act as a team leader by ensuring daily processes are complete, scheduling employees, answering employee questions, and assisting with orientation and training.
Communicate professionally with physicians, care management, ancillary departments, nursing units, physicians’ office staff, insurance companies, patients, and families; complete thorough and accurate documentation.
Follow university policies, procedures, and standards, including requirements for time management, supply management, productivity, and accuracy.
Maintain professional growth and development through required continuing education and competency activities; 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.
Paid holidays, a preventative leave day, vacation, and sick time; approximately 37–38 days per year in total.
Vacation accrual increases with length of service.
Longevity pay through 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.