Patient Access Representative III

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.

As a Patient Access Representative, you will manage administrative duties for the patient intake process in our clinic, adhering to established guidelines.

Every day you will interact with patients in person and by phone, facilitating check-in/out, collecting data and payments, validating insurance, scheduling appointments, and processing referrals and authorizations.

To be successful, you will demonstrate critical thinking, strong customer service, and knowledge of insurance, billing, and medical terminology, ensuring a seamless, high-quality patient intake experience.

• Assist in providing access to services provided at the hospital.
• Knowledge of all tasks performed in the various Verification/Pre‐certification area is necessary to provide optimum internal and external customer satisfaction and provide the opportunity for accurate reimbursement.
• The position basic function is for the verification of eligibility/benefits information for the patient's visit, obtaining Pre‐cert/Authorization/Notifying Third Party payers within compliance of contractual agreements with a high degree of accuracy.
• Participates in upfront collections by informing the patient of the estimated patient portion during insurance verification.
• Responsible for establishing the hospital's financial expectation for the patient and/or guarantor and ensuring accurate information is exchanged which determines whether the account will be processed in an efficient and expedient manner for the hospital and the patient.

Required Education and Experience

• High School Diploma/GED
• Two (2) years of related experience
• Preferred: Scheduling and Oncology experience

Required Minimum Knowledge, Skills, Abilities and Training

• Extended knowledge of HMO’s, PPO’s, Commercial/Governmental payers and System/Entity specific hospital contracts with Third Party payers.
• Extended knowledge of HIPPA and EMTALA.
• Preferred: Knowledge of Epic systems and use of decision trees.