Patient Access Representative Full-timeDays

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

• Actively supports the organizations 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 allinclusive; 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 postsecondary 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 ongoing 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 coworkers in a manner consistent with a customer service focus and application of positive language principles

• Ability to analyze and solve problems

• Ability to multitask 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

ONCALL*
*Note that employees may be required to be oncall 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 West Hospital is committed to leading medicine in West Houston Katy and surrounding communities by delivering the Houston Methodist standard of exceptional safety quality personalized service and innovation. The growing campus offers more than 200 beds 19 operating rooms and over 1500 employees with access to the most innovative medical and surgical care available including robotic and minimally invasive surgery fullspectrum heart care stateoftheart imaging cancer care labor and delivery with a level II neonatal ICU neurology and neurosurgery orthopedics and sports medicine outpatient rehabilitation and 24/7 emergency services.