Patient Access Center Representative

About the role

Come lead with us at Corporate at Houston Methodist as a Patient Access Center Representative. This position ensures patients receive timely scheduling, accurate registration, and financial clearance prior to their appointments. You will work with management to identify process improvements, conduct audits, and deliver excellent customer service to patients, physicians, and staff. You will also notify relevant parties of potential service delays or reimbursement denials.

Responsibilities

People Essential Functions

• Use critical thinking and healthcare knowledge to manage scheduling across primary care, specialty care, and ancillary services.
• Apply independent judgment to accommodate special requests from internal and external customers.
• Serve as the front door for Houston Methodist, interacting with new and established patients to provide scheduling and registration information.
• Use computerized scheduling/registration systems, verification systems, and online applications while balancing departmental resources.
• Obtain required data to support departmental and hospital clinical/financial needs.
• Triage calls for the System Patient Access Center according to management guidelines and scripts.
• Provide patients with information to prepare for appointments per Center/Service protocol.
• Encourage patients to enroll on the Patient Portal and provide PIN numbers in compliance with HIPAA regulations.
• Follow established protocols and utilize multiple software applications to schedule appointments.
• Maintain open communication with physicians, patients, and service areas regarding actions taken and resolutions.
• Promote a friendly and professional customer service environment.

Service Essential Functions

• Use courteous and professional telephone techniques and interpersonal skills to establish and maintain rapport with patients, physicians, office personnel, and hospital staff while maintaining patient confidentiality.
• Appropriately utilize the telephone system and department scripting to meet ICARE values.
• Assist with new referrals from E-fax and emails, and schedule emergency patients same day or within 24 hours as needed.
• Coordinate workflow to assist patients with appointment scheduling and service requests.
• Collect and compile patient data such as insurance documentation and identification information to facilitate appointments.
• Screen and assess patient calls to ensure accurate scheduling per physician or patient request.
• Schedule patient appointments and efficiently complete registration.
• Answer incoming calls and act as a liaison between patients and physicians or clinical staff.
• Handle calls from physician offices or hospital departments while maintaining positive relationships and obtaining necessary documentation.
• Facilitate, coordinate, and resolve patient issues using exceptional telephone, verbal, written, critical thinking, and interpersonal communication skills.

Quality/Safety Essential Functions

• Adhere to scheduling processes and workflows in the electronic medical record platform while maintaining privacy and HIPAA compliance.
• Maintain productivity standards and meet scheduling goals (e.g., abandonment rate, productivity per hour).
• Verify patient insurance and ensure required data supports departmental and hospital needs.
• Ensure verification and eligibility procedures are followed prior to patient visits.

Finance Essential Functions

• Partner with the revenue cycle team and other departments to ensure correct and complete scheduling and registration prior to patient visits.
• Enter accurate scheduling and registration data, including patient demographics, insurance, guarantor, and clinical information to initiate financial clearance activities.
• Document patient accounts with information about potential issues that could cause service delays or cancellations due to lack of financial clearance.

Growth/Innovation Essential Functions

• Work with physicians, clinic staff, hospital departments, and patients to ensure best practices within the department.
• Collaborate with management to improve areas of concern, embrace change, and strive for workplace excellence.
• Apply new learning and share knowledge with others.

Requirements

• High School diploma or equivalent (e.g., GED, homeschool equivalency, partial or full post-secondary education).
• Three years of experience in a healthcare setting, call center, or customer service operations, or successful completion of the one-year Houston Methodist Call Center Apprenticeship.
• Healthcare setting knowledge and experience with a strong understanding of medical terminology preferred.

Licenses and Certifications

• Required credentials as outlined by Houston Methodist.

Skills

• Sufficient proficiency in speaking, reading, and writing English to ensure patient and employee safety.
• Excellent communication and interpersonal skills via telephone and in person.
• Demonstrated proficiency in medical terminology, including diagnoses, operative procedures, and CPT codes.
• Excellent spelling and grammar skills.
• Working knowledge of PC environments using Windows, word processing, and basic Excel; able to enter data via keyboard throughout the work schedule.
• Capable of working with 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.

Work Attire

• Uniform: No
• Scrubs: No
• Business professional: Yes
• Other (department approved): No

On-Call

• Note: Employees may be required to be on-call during emergencies (e.g., disasters, severe weather events) regardless of selection below.
• On-Call: No

Travel

• May require travel within the Houston Metropolitan area: Yes
• May require travel outside Houston Metropolitan area: No