PATIENT ACCESS REPRESENTATIVE

At Houston Methodist, the Patient Access Representative position is responsible for performing multiple patient access functions on a daily basis to include any combination of the following: scheduling, insurance verification, and registration. This position serves as the liaison between groups such as patients, staff, physicians/physician offices, insurance providers, and others for routine matters as the primary point of contact for resolving questions and issues as they relate to the scope of the department. This position is also responsible for obtaining and entering accurate scheduling, insurance, and registration data into the various operational systems to initiate financial clearance activities. Other duties may include transcribing orders or verifying referrals as pertinent to the scope of the department.

PATIENT AGE GROUP(S) AND POPULATION(S) SERVED
Refer to departmental Scope of Service and Provision of Care plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity.

HOUSTON METHODIST EXPERIENCE EXPECTATIONS

• Provide personalized care and service by consistently demonstrating our I CARE values:
  • INTEGRITY: We are honest and ethical in all we say and do.
  • COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
  • ACCOUNTABILITY: We hold ourselves accountable for all our actions.
  • RESPECT: We treat every individual as a person of worth, dignity, and value.
  • EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.

• Practices the Caring and Serving Model

• Delivers personalized service using HM Service Standards

• Provides for exceptional patient/customer experiences by following our Standards of Practice of always using Positive Language (AIDET, Managing Up, Key Words)

• Intentionally collaborates with other healthcare professionals involved in patients/customers or employees' experiential journeys to ensure strong communication, ease of access to information, and a seamless experience.

• Involves patients (customers) in shift/handoff reports by enabling their participation in their plan of care as applicable to the given job

• Displays cultural humility, diversity, equity and inclusion principles

• Actively supports the organization's vision, fulfills the mission and abides by the I CARE values

PEOPLE ESSENTIAL FUNCTIONS

• Promotes a positive work environment and contributes to a dynamic team focused work unit that actively helps one another to achieve optimal departmental and organizational results.

• Serves as a liaison between patients, staff, physicians/physician offices, insurance providers, and others for routine matters as the primary point of contact for resolving questions and issues as they relate to the scope of the department.

SERVICE ESSENTIAL FUNCTIONS

• Performs multiple patient access functions on a daily basis to include any combination of the following: scheduling, insurance verification, and registration. May assist with obtaining clinical information, medical records, valid and complete orders or referrals, or other related tasks, resolving issues as needed.

• Contributes to patient flow as directed with consistency, timeliness, and skill while meeting appropriate priority standards. Provides appropriate notification of issues that may result in service delays or denials.

• Contributes to patient, employee, and physician satisfaction as well as effective revenue cycle process.

• Generates reports, assists with department correspondence, and provides other administrative assistance as directed.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Enters and updates patient and operational data into various database systems with a high level of thoroughness, accuracy and timeliness.

• Communicates to resolve patient access and quality service matters. Keeps open channels of communication with physician, patient, and service areas regarding action taken and outcome.

• Ensures patient information is conveyed to others appropriately while complying with patient confidentiality and HIPAA regulations.

FINANCE ESSENTIAL FUNCTIONS

• Accurately records information when performing functions such as registration, scheduling, and insurance verification/coordination to ensure financial objectives are met. Conducts front end revenue cycle duties such as collecting payments as needed. Educates patients and others regarding billing processes and potential financial responsibilities as necessary.

• Organizes time effectively, minimizing incidental overtime, and sets priorities. Utilizes time between heavy workloads efficiently and helps other team members.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• Displays initiative to improve job functions; offers suggestions to streamline process for efficient patient flow and other quality or service matters.

• Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development.

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

EDUCATION

• High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

WORK EXPERIENCE

• Three years of experience in a healthcare environment, to include experience in registration, scheduling, insurance verification, and/or business office

LICENSES AND CERTIFICATIONS - REQUIRED

• N/A

KNOWLEDGE, SKILLS, AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations

• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security

• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles

• Ability to analyze and solve problems

• Ability to multi-task and flexibility to meet the needs of patients, physicians, and department

• Knowledge of basic registration/access functions and insurance procedures

• Basic understanding of medical terminology and diagnosis/procedural codes

• Ability to remain calm in stressful situations with patience and understanding

• Excellent customer service and professional communication skills

• Proficient computer skills and ability to learn and navigate multiple software programs

• Ability to handle detail work accurately and rapidly

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

• Uniform Yes
• Scrubs No
• Business professional Yes
• Other (department approved) Yes

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

• On Call* No

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area Yes
• May require travel outside Houston Metropolitan area No

Houston Methodist The Woodlands opened in 2017 as the eighth hospital in the Houston Methodist system. This 187-bed, 470,000-square-foot, full-service, acute care hospital offers many of the same services as our flagship hospital in the Texas Medical Center. Also on the $380 million hospital campus, located at the intersection of I-45 and TX 242, is a medical office building, which opened in 2016. Medical Office Building 1 includes a breast care center, cancer center & infusion center, orthopedics & sports medicine, rehabilitation services, wellness services, and an outpatient laboratory in addition to multi-specialty physician practices. A second medical office building and 785-car parking garage opened in 2018.