Patient Access Representative I / II / Senior - Memorial Villages Orthopedics (Finance)

Position Summary:

Responsible for ensuring medical necessity compliance, verifying eligibility, and posting payments.

Position Key Accountabilities:

1. Obtains demographic, insurance and financial information from patient or guarantor. Enters information in computer system with a high degree of accuracy.
2. May schedule patient appointments and enter required information in the computer system in an accurate and timely manner.
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. 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.
9. Adheres to all university policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.
10. 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.
11. Performs other duties as assigned.

Certification/Skills:

Ability to multi-task.
Proficient typing/keyboarding skills.

Minimum Education:

High School Diploma or equivalent

Minimum Experience:

One (1) year 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 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

Residency Requirement:

Employees must permanently reside and work in the State of Texas.