Patient Access Representative II

Baylor St. Luke’s Medical Center is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in cardiovascular care neuroscience oncology transplantation and more. Our team’s efforts have led to the creation of many research programs and initiatives to develop advanced treatments found nowhere else in the world. In our commitment to advancing standards in an ever-evolving healthcare environment our new McNair Campus is designed around the human experience—modeled on evidence-based practices for the safety of patients visitors staff and physicians. The 27.5-acre campus represents the future of healthcare through a transformative alliance focused on leading-edge patient care research and education. Our strong alliance with Texas Heart® Institute and Baylor College of Medicine allows us to bring our patients a powerful network of care unlike any other. Our collaboration is focused on increasing access to care through a growing network of leading specialists and revolutionizing healthcare to save lives and improve the health of the communities we serve.

The Patient Access Rep II is responsible for identifying and collecting patient financial obligation for the duration of stay as well as verifying the eligibility/benefits information for the patient’s visit. This position will also determine eligibility for the hospital’s various financial assistance programs.

ESSENTIAL KEY JOB RESPONSIBILITIES

1. Performs collection functions and financial assistance for payment methods
2. Conducts interviews with patients and/or family members
3. Collect and/or negotiate point of service payments or link to financial assistance programs
4. Must be capable of articulating information in a courteous, clear and informative manner to patients, guarantors, family members, clinical staff, other hospital personnel, vendors, physicians, and their office staff
5. Convey estimates of the patient responsibility portion of the billed cost of service to patients under deductible, coinsurance, and standard co-pay benefit designs based on established charge estimates for common procedures
6. Counsels patients regarding their third-party coverage, financial responsibility, and billing procedures
7. Review patient account summaries of unbilled charges, billing, payments, and collection activities
8. Obtain all forms required for patients potentially qualifying for financial assistance
9. Review and monitor accounts for inpatients and initiate proper action
10. Ensures payors are listed accurately, pertaining to primary, secondary, and/or tertiary coverage and billing when a patient has multiple third party/governmental payors listed on an account.
11. Process patient accounts and deploy established policies to resolve insurance issues with patient accounts with/without supervision i.e. conference calls with employer, payor and physician office staff
12. Initiate pre-cert for in-house patients when required, obtaining pre-certification reference number, approved length of stay, and utilization review company contact person and telephone number

Education and Experience Required:

High School diploma / GED

One (1) year of revelant experience 

Preferred:  Experience with Epic

Minimum Knowledge, Skills, and Abilities:
• Excellent customer service skills
• Excellent Written/verbal communication skills
• Math skills
• Computer literate
• Detail oriented
• Basic knowledge of medical terminology

DISCLOSURE STATEMENT

The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.