Sr Patient Access Associate

Overview

At Houston Methodist, the Senior Patient Access Associate position is responsible for obtaining and entering accurate demographic and insurance information in the electronic health record (EHR) on patients presenting at the various entry points of the facility. This position performs cashiering functions, ensuring that all hospital accounts are secure, through the collection of the required co-pay, deductibles and co-insurance. This position also performs the medical necessity check to ensure compliance with Medicare guidelines and regularly works in multiple areas (e.g., emergency department registration, main registration, bed management, cashier, etc.) and/or EHR work queues specific to patient access. The Senior Patient Access Associate employs effective communication skills, promoting excellent customer service in every interaction, and serves as a resource, trainer, and mentor to other team members. This position is also required to adhere to all departments, hospital, governmental, and/or any other healthcare licensing agency requirements related to the Emergency Medical Treatment and Labor Act (EMTALA) and the Health Insurance Portability and Accountability Act (HIPAA).

Houston Methodist Standard

PATIENT AGE GROUP(S) AND POPULATION(S) SERVED Refer to departmental "Scope of Service" and "Provision of Care" plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity.

HOUSTON METHODIST EXPERIENCE EXPECTATIONS

- Provide personalized care and service by consistently demonstrating our I CARE values:

- INTEGRITY: We are honest and ethical in all we say and do.

- COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.

- ACCOUNTABILITY: We hold ourselves accountable for all our actions.

- RESPECT: We treat every individual as a person of worth, dignity, and value.

- EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.

- Practices the Caring and Serving Model

- Delivers personalized service using HM Service Standards

- Provides for exceptional patient/customer experiences by following our Standards of Practice of always using Positive Language (AIDET, Managing Up, Key Words)

- Intentionally collaborates with other healthcare professionals involved in patients/customers or employees' experiential journeys to ensure strong communication, ease of access to information, and a seamless experience.

- Involves patients (customers) in shift/handoff reports by enabling their participation in their plan of care as applicable to the given job

- Actively supports the organization's vision, fulfills the mission, and abides by the I CARE values

Responsibilities

PEOPLE ESSENTIAL FUNCTIONS

- Promotes a positive work environment and contributes to a dynamic team-focused work unit that actively helps one another to achieve optimal departmental and organizational results.

- Communicates openly in a non-judgmental manner and in a professional demeanor during all interactions with customers and co-workers.

- Serves as a resource and trainer for less experienced and new staff; orients, guides, and mentors team members to help build confidence and competency in skills, knowledge, and abilities.

SERVICE ESSENTIAL FUNCTIONS

- Obtains and records accurate demographic and insurance information on patients by interviewing patients, family members, and physicians. Ensures that the correct insurance plan codes are utilized for the billing process.

- Explains the consent forms, obtains signatures on the forms, and responds to any questions in a professional manner.

- Regularly works in multiple areas (e.g., emergency department registration, main registration, bed management, cashier, etc.) and/or EHR work queues specific to patient access.

- Contributes to departmental and hospital patient experience. Proactively seeks solutions to address patient issues and concerns. Serves as a second-level resource to address elevated registration issues. Alerts management in a timely manner to any unusual and/or difficult situations impacting the level of service.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

- Consistently takes the necessary steps to ensure that protected health information remains private and confidential, according to established HIPAA guidelines. Uses patient identifiers consistently to properly identify patients and the correct medical records. Refrains from issuing new medical record numbers to patients with existing accounts.

- Meets goals set by the department (e.g., registration error rate, productivity/activities per hour, etc.).

FINANCE ESSENTIAL FUNCTIONS

- Ensures that ordered services meet established medical necessity criteria when applicable.

- Collects payments based on pre-determined information. Performs insurance verification to determine patient out-of-pocket expenses for services. If applicable, offers payment options after the minimum required payment has been received. Fulfills monthly goals for cash collection.

- Accurately posts and receipts patient payments. Balances cash drawer on a daily basis; follows the department policy related to cash drawers and cash receipting.

- Organizes time effectively, minimizing incidental overtime and sets priorities. Utilizes time between heavy workloads efficiently and helps other team members.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

- Displays initiative to improve job functions. Demonstrates adaptability and flexibility during changing demands. Offers suggestions to streamline process for efficient patient flow.

- Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development.

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.

Qualifications

EDUCATION

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

WORK EXPERIENCE

- Four years of customer service experience to include two years of experience in hospital registration

License/Certification

LICENSES AND CERTIFICATIONS - REQUIRED

- N/A

KSA/ Supplemental Data

KNOWLEDGE, 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

- Ability to multi-task and flexibility to meet the requirements of the patients and the department

- Knowledge of basic registration/access functions and insurance procedures

- Ability to problem solve

- Ability to remain calm in stressful situations with patience and understanding

- Excellent customer service and professional communication skills

- Proficient computer skills and ability to learn and navigate multiple software programs

- Ability to handle detail work accurately and rapidly

- Strong training, leadership, and mentoring skills

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

- Uniform Yes
- Scrubs No
- Business professional Yes
- Other (department approved) Yes

ON-CALL**Note that employees may be required to be on-call during emergencies (i.e., Disaster, Severe Weather Events, etc.) regardless of selection below.

- On Call* No

TRAVEL****Travel specifications may vary by department**

- May require travel within the Houston Metropolitan area No
- May require travel outside Houston Metropolitan area No

Company Profile

Since its founding in 1919, Houston Methodist Hospital has earned worldwide recognition. Houston Methodist Hospital is affiliated with the Weill Medical College of Cornell University and New York-Presbyterian Hospital, one of the nation's leading centers for medical education and research. In 2020, U.S. News & World Report named Houston Methodist Hospital to its top ranked Honor Roll for the fourth time and second consecutive year. 2020 also marked the ninth year in a row Houston Methodist Hospital has been named the No. 1 hospital in Texas. Houston Methodist Hospital directs millions of research dollars into patient care and offers the latest innovations in medical, surgical, and diagnostic techniques. With 952 operating beds, 85 operating rooms, and over 8,000 employees, Houston Methodist offers complete care for patients from around the world.

The same high-quality care for which Houston Methodist is known is available at several Emergency Care Centers in Houston and the surrounding areas. These Emergency Care Centers house exam rooms, full digital radiography suite, low radiation dose 16-slice CT scan, ultrasound, and a full on-site stat chemistry lab.

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