Patient Access Center Representative

At Houston Methodist, the Patient Access Center Representative position is responsible for assuring that patients in need of scheduling appointments are scheduled to receive services in their assigned location and are financially cleared prior to their scheduled appointment through accurate and timely scheduling, registration, and verification of eligibility and benefits. This position assists management with ongoing observations and notifications of opportunities while providing innovative suggestions for process improvement. The Patient Access Center Representative position also assists management with auditing/quality review to ensure accurate and appropriate scheduling and registration. Additional responsibilities for this position include providing excellent customer service when communicating with patients who receive services at our facilities and providing notification to patients, physicians, hospital/clinical staff and management of issues that may result in potential service delays or reimbursement denials.

FLSA STATUS

Non-exempt

QUALIFICATIONS

EDUCATION

High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

EXPERIENCE

Three years of experience in healthcare setting/call center or customer service operations or successful completion of one-year Houston Methodist Call Center Apprenticeship in lieu of years of experience Healthcare setting knowledge and experience with a strong understanding of medical terminology preferred

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 co-workers in a manner consistent with a customer service focus and application of positive language principles Excellent communication and interpersonal skills via telephone and in person Demonstrated proficiency in medical terminology to include diagnoses, operative procedures, and CPT codes Knowledge of medical terminology and applicability Excellent spelling/grammar skills Working knowledge of PC environment utilizing Windows and word processing and basic Excel knowledge; must be able to enter data via keyboard throughout the work schedule Capable of working and navigating several applications and websites related to registration simultaneously Managed care knowledge with the ability to differentiate between insurance plans such as PPO, POS, HMO, etc.

PEOPLE ESSENTIAL FUNCTIONS

Demonstrates ability to use critical thinking skills and healthcare knowledge to manage through primary care, specialty care, and ancillary scheduling processes. Utilizes independent judgment to accommodate special requests from internal and external customers as indicated. Serves as the front door of Houston Methodist interacting with new and established patients providing them with information needed to schedule and register multiple services for Houston Methodist. Utilizes computerized scheduling/registration systems, verification systems, and online applications while balancing departmental resources. Obtains required data in order to support departmental and hospital clinical/financial needs. Triages calls for the System Patient Access Center as appropriate to other areas as received on a daily basis while working under the guidelines and scripts as set forth by management. Provides patients with information needed to prepare for appointment per Center/Service protocol. Encourages patients to enroll on the Patient Portal and provides PIN numbers, complying with HIPAA regulations. Follows established protocols directly as indicated by management and physicians on applicable platforms on an as needed basis and consistently utilizes multiple software applications to schedule appointments. Keeps open channels of communication with all parties involved, including physician, patient, and service areas, regarding action taken and resolution. Promotes a friendly and professional customer service environment.

SERVICE ESSENTIAL FUNCTIONS

Utilizes courteous and professional telephone techniques and interpersonal skills to establish and maintain rapport with patients, physicians/office personnel and various hospital personnel, while maintaining patient confidentiality. Appropriately utilizes telephone system. Uses department scripting and appointment scheduling policy when scheduling appointments and ensures ICARE values are met while working within the scripting provided. Assists with new referral from E-fax and emails along with specific doctors’ offices calling directly to schedule emergency patients’ same day or within 24 hours as needed. Coordinates the workflow to assist patients with appointment scheduling and/or requests for services: Collects and compiles data/information from patients such as insurance documentation and patient identification information to help facilitate an appointment. Screens and assesses patient calls received and assures that the patients are scheduled for services as requested by referring physician or upon patient’s request. Schedules patient appointments. Efficiently completes registration. Answers incoming calls from patients. Acts as liaison between the patient and the physician or clinical staff. Handles calls from physician offices or hospital departments, always making sure to maintain a good relationship and obtain all necessary documents needed to support the scheduling process.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

Adheres to scheduling processes and workflows as defined in #J-18808-Ljbffr Houston Methodist