Patient Access Representative II
4 weeks ago
UTHealth Houston is seeking a highly skilled Patient Access Representative II to join our team. As a Medical Necessity Specialist, you will play a critical role in ensuring medical necessity compliance, verifying eligibility, and posting payments.
Key Responsibilities- Obtain demographic, insurance, and financial information from patients or guarantors and enter it into the computer system with high accuracy.
- Schedule patient appointments and enter required information in the computer system in a timely and accurate manner.
- Explain required forms to patients or guarantors and obtain necessary signatures.
- Ensure medical necessity compliance by obtaining necessary data, reviewing the Compliance System, communicating information to patients or guarantors, and obtaining necessary signatures.
- Protect the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options, and screening for eligibility.
- Complete complex financial counseling, including reviewing and submitting charity applications, identifying alternative resources for financial reimbursement, verifying insurance eligibility and benefits, and ensuring all notifications and authorizations are completed within required timeframes.
- Post payments in the computer system and generate patient receipts.
- Communicate effectively and professionally with physicians, care management, ancillary departments, nursing units, physicians' office staff, insurance companies, patients, and their families.
- Complete thorough and accurate documentation and adhere to all university policies, procedures, and standards.
- Promote individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supporting department-based goals, and serving as a preceptor, mentor, and resource to less experienced staff.
- Ability to multitask and proficient typing/keyboarding skills.
- High school diploma or equivalent and two years of experience in a hospital or medical business office setting.
- Physical requirements include exerting up to 50 pounds of force occasionally, and/or up to 20 pounds of force frequently, and/or up to 10 pounds constantly to move objects.
UTHealth Houston offers a comprehensive and competitive benefits package, including 100% paid medical premiums for full-time employees, generous time off, longevity pay, and a retirement/pension plan.
We take care of our employees by offering work/life services, such as free financial and legal counseling, free mental health counseling services, gym membership discounts, and access to wellness programs.
UTHealth Houston is an equal opportunity employer and welcomes applications from diverse candidates.
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