Patient Access Representative

6 days ago


League City, Texas, United States Memorial Hermann Health System Full time
Job Summary

This role is responsible for coordinating patient appointments, ensuring medical necessity compliance, verifying eligibility, and processing payments. The ideal candidate will have a strong background in customer service and experience working in a hospital or healthcare setting.

Key Responsibilities
  • Scheduling and Coordination
    • Schedule patient appointments and enter required information in the computer system in an accurate and timely manner.
    • Obtain demographic, insurance, and financial information from patients or guarantors and enter it into the computer system with a high degree of accuracy.
  • Medical Necessity Compliance
    • Ensure medical necessity compliance by obtaining necessary data, reviewing the Compliance System, communicating information to patients or guarantors, and obtaining necessary signatures.
  • Financial Management
    • Protect the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options, and screening for eligibility.
    • Verify insurance eligibility and benefits and ensure all notifications and authorizations are completed within the required timeframes.
    • Post payments in the computer system and generate the appropriate patient receipts.
  • Communication and Customer Service
    • Communicate in an effective and professional manner with physicians, ancillary departments, nursing units, physicians' office staff, insurance companies, as well as patients and their families.
    • Complete thorough and accurate documentation.
  • Quality and Safety
    • Ensure safe care to patients, staff, and visitors, adhere to all Memorial Hermann policies, procedures, and standards within budgetary specifications, including time management, supply management, and productivity of service.
  • Professional Development
    • Promote individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, and support department-based goals which contribute to the success of the organization.
    • Serve as a preceptor, mentor, and resource to less experienced staff.
Requirements
  • Education
    • High School Diploma or GED preferred.
  • Experience
    • Two (2) years of experience in a hospital or customer service setting.
  • Skills
    • Ability to multi-task.
    • Proficient typing/keyboarding skills.


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