JOB TITLE
Sr. Patient Access Representative
POSITION SUMMARY
Position is responsible for mentoring other employees as a team leader, scheduling patient appointments, ensuring medical necessity compliance, verifying eligibility, and posting payments.
POSITION KEY ACCOUNTABILITIES
1. Schedules patient appointments and enters required information in the computer system in an accurate and timely manner.
2. Obtains demographic, insurance and financial information from patient or guarantor. Enters information in computer system with a high degree of accuracy.
3. Explains all required forms to the patient or guarantor and obtains the necessary signatures.
4. Ensures medical necessity compliance by obtaining necessary data, reviewing Compliance System, communicating information to patient or guarantor and obtaining necessary signatures.
5. Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility. Completes complex financial counseling including the review and submission of charity applications. Identifies alternative resources for financial reimbursement.
6. Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes.
7. Posts payments in the computer system and generates the appropriate patient receipts.
8. Monitors, reviews and resolves patient account issues on assigned reports. Performs account analysis and trending.
9. Completes quality review and monitors for process improvement opportunities.
10. Functions as a team leader in the department by ensuring daily processes are complete, scheduling employees, providing answers to employee questions and assisting in employee orientation and training.
11. Communicates in an effective and professional manner with Physicians, Care Management, ancillary departments, nursing units, physicians office staff, insurance companies, as well as patients and their families (all Patient Access customers). Completes thorough and accurate documentation.
12. Adheres to all university policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.
13. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
14. Performs other duties as assigned.
CERTIFICATIONS/SKILLS
Ability to multi-task.
Proficient typing/keyboarding skills.
MINIMUM EDUCATION
High school diploma or equivalent.
MINIMUM EXPERIENCE
Four years of experience in a hospital or medical business office setting.
PHYSICAL REQUIREMENTS
Exerts 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.
SECURITY SENSITIVE: This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code 51.215 •
Last updated on Apr 9, 2020