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Patient Access Representative I 6p-6:30a Sat, Sun, & 2 varied weekdays
Patient Access Representative I 6p-6:30a Sat, Sun, & 2 varied weekdaysMemorial Hermann • Houston, TX, US
Patient Access Representative I 6p-6 : 30a Sat, Sun, & 2 varied weekdays

Patient Access Representative I 6p-6 : 30a Sat, Sun, & 2 varied weekdays

Memorial Hermann • Houston, TX, US
1 day ago
Job type
  • Full-time
Job description

Medical Necessity Compliance Specialist

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Description

Minimum Qualifications

Education : High School Diploma or GED preferred

Licenses / Certifications : (None)

Experience / Knowledge / Skills :

  • Prior experience in a business office or customer service setting
  • Proficient typing / keyboarding skill

Principal Accountabilities

  • Obtains demographic, insurance and financial information from patient or guarantor. Enters information in computer system in an accurate manner.
  • Explains all required forms to the patient or guarantor and obtains the necessary signatures.
  • Ensures medical necessity compliance by obtaining necessary data, reviewing Compliance System, communicating information to patient or guarantor and obtaining necessary signatures.
  • Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility.
  • Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes.
  • Posts payments in the computer system and generates the appropriate patient receipts.
  • Communicates in an effective and professional manner with Physicians, ancillary departments, nursing units, physicians' office staff, insurance companies, as well as patients and their families. Completes thorough and accurate documentation.
  • Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
  • 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.
  • Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
  • Other duties as assigned.
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    Patient Representative • Houston, TX, US

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