Patient Access Representative Pt Access\ECNIGHT\WKND\EVENING (Part Time Sat & Sun 7pm 7am)Bookmark This
Texas Children's Hospital
Job Title: Patient Access Representative -Pt Access/ECNIGHT/WKND/EVENING (Part Time Sat Sun 7pm-7am) Job ID: 126412 Location: Medical Center, Houston, TX Full/Part Time: Part-Time Regular/Temporary: Regular Shift: Part Time 7pm-7am Saturday Sunday
Salary Grade: 7 Texas Children's Hospital is an internationally recognized full-care pediatric hospital located in the Texas Medical Center in Houston. One of the best pediatric hospitals in the United States, Texas Children's Hospital is dedicated to providing the finest possible pediatric patient care, education and research.
Texas Children's is nationally ranked in the top five among children's hospitals by both Child magazine and U.S. News World Report. The hospital has garnered widespread recognition for its expertise and breakthrough developments in the treatment of cancer, diabetes, asthma, HIV, premature babies, and cardiogenic and attention-related disorders.
No third party considerations will be accepted at this time. Vendors please do not call HR directly to solicit. Overview:
Identify patient identification number which is used to facilitate the billing of charges and to track a patient's care. Secure the financial integrity of each account to maximize reimbursement, including meeting any and all contractual requirements of managed care companies (precertification, authorizations, etc.). Ensure compliance with EMTALA and other state or federal regulations.
Accurately identify patient and assign a unique patient identification number (medical record number). Ensure scheduled patients are pre-registered. Obtain pre-authorization for outpatient services and document authorization information. Provide insurance company with admission notification for unscheduled inpatients. Verify insurance benefits and select the correct plan code for outpatient diagnostic or day surgery account. Ensure patient liability portion determined through discussion with the insurance company. Follow up with the patient's family or guarantor to discuss financial arrangements for co-pays, deductibles, non-covered services and any other out of pocket amount. Identify proper source for authorization. Refer inpatient accounts for insurance verification and financial counseling. For patients who are admitted as inpatient from outpatient clinic areas: verify inpatient benefits, provide insurance notification of admission, notify bed control and begin the registration process. Maximize efficiency and accuracy of the collection process by accurately inputting the patient's demographic and financial information. Provide documentation in the patient's chart of general consent, information release, advanced care directives and other requirements of JCAHO and other regulatory bodies.
Knowledge and Skills:
Knowledge of managed care industry, including an insurance company's role as a claims payor or a claims administrator and their related utilization review process. Knowledge of indemnity coverage plans and government resources, specifically Medicaid and CSHCN. Ability to predict outcomes based on existing processes and/or checks and balances, the ability to use a personal computer, office software and modem-based query software for verification of insurance benefits and the ability to demonstrate self-initiated work behaviors, good verbal communication skills and excellent customer service skills.
Education and Experience:
High school diploma or equivalent; minimum of six (6) months of experience as an admission representative/counselor performing all aspects of the registration process is required (in lieu of actual work experience, an Associate's or Bachelor's degree may be substituted).