Houston Methodist
Patient Access Center Representative - Referral Management (Katy)
Houston Methodist, Katy, Texas, United States, 77493
Patient Access Center Representative
At Houston Methodist, the Patient Access Center Representative position is responsible for assuring that patients referred between employed and aligned physicians 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 visit our clinics and providing notification to patients, physicians and management of issues that may result in potential service delays or reimbursement denials. The Patient Access Center Representative position also: Demonstrates ability to use critical thinking skills and healthcare knowledge to manage through primary care and specialty care scheduling processes. Utilizes independent judgement to accommodate special requests from internal and external customers as indicated. Serves as the front door of the Physician Organization interacting with new and established patients providing them with information needed to schedule and register multiple services for the Physician Organization. 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 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. Enrolls patients on the Patient Portal and provides PIN numbers, complying with HIPAA regulations. Follows clinical protocols directly as indicated by Kyruss Provider Match, management, and physicians on an as needed basis and consistently manages 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. This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises. The qualifications for this position include: High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.) 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 Licenses and certifications: CMA - Certified Medical Assistant -- Satisfactory program completion and clinical licensure OR LVN - Licensed Vocational Nurse - State Licensure -- Satisfactory program completion and clinical licensure Knowledge, skills, and abilities: Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going 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. Supplemental requirements: Work Attire: Business professional On-Call: Yes Travel: May require travel within the Houston Metropolitan area Houston Methodist (HM) is one of the nation's leading health systems and academic medical centers. HM consists of eight hospitals, an academic institute, a comprehensive residency program, a global business division, numerous physician practices and several free-standing emergency rooms and outpatient facilities. Overall, HM employs over 25,000 employees. In 2019 Houston Methodist and its physicians treat more than 6,333 international patients from more than 76 countries. Houston Methodist Global Health Care Services' consulting and education divisions also provide advisory services and training and development to health care organizations around the world.
At Houston Methodist, the Patient Access Center Representative position is responsible for assuring that patients referred between employed and aligned physicians 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 visit our clinics and providing notification to patients, physicians and management of issues that may result in potential service delays or reimbursement denials. The Patient Access Center Representative position also: Demonstrates ability to use critical thinking skills and healthcare knowledge to manage through primary care and specialty care scheduling processes. Utilizes independent judgement to accommodate special requests from internal and external customers as indicated. Serves as the front door of the Physician Organization interacting with new and established patients providing them with information needed to schedule and register multiple services for the Physician Organization. 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 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. Enrolls patients on the Patient Portal and provides PIN numbers, complying with HIPAA regulations. Follows clinical protocols directly as indicated by Kyruss Provider Match, management, and physicians on an as needed basis and consistently manages 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. This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises. The qualifications for this position include: High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.) 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 Licenses and certifications: CMA - Certified Medical Assistant -- Satisfactory program completion and clinical licensure OR LVN - Licensed Vocational Nurse - State Licensure -- Satisfactory program completion and clinical licensure Knowledge, skills, and abilities: Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going 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. Supplemental requirements: Work Attire: Business professional On-Call: Yes Travel: May require travel within the Houston Metropolitan area Houston Methodist (HM) is one of the nation's leading health systems and academic medical centers. HM consists of eight hospitals, an academic institute, a comprehensive residency program, a global business division, numerous physician practices and several free-standing emergency rooms and outpatient facilities. Overall, HM employs over 25,000 employees. In 2019 Houston Methodist and its physicians treat more than 6,333 international patients from more than 76 countries. Houston Methodist Global Health Care Services' consulting and education divisions also provide advisory services and training and development to health care organizations around the world.