Patient Access Center Representative

About the Role

Lead the Patient Access Center at Houston Methodist by scheduling appointments, verifying eligibility and benefits, and ensuring patients are financially cleared prior to their visits. The role includes providing excellent customer service, notifying patients, physicians, and staff of potential service delays or reimbursement issues, and assisting management with observations, process‑improvement suggestions, and auditing/quality review.

Qualifications

• Education: High School diploma or equivalent (GED, homeschool equivalency, partial or full post‑secondary education, etc.).
• Experience: Three years in a healthcare setting, call center, or customer‑service operations; or successful completion of a one‑year Houston Methodist Call Center Apprenticeship in lieu of experience. Knowledge of healthcare settings and strong understanding of medical terminology preferred.
• Licenses and Certifications: Required (specific license not listed).
• FLSA Status: Non‑exempt.

Required Skills and Abilities

• Demonstrated competence to safely perform assigned duties, verified through ongoing assessments.
• Proficiency in speaking, reading, and writing English, especially for activities impacting patient or employee safety.
• Effective communication with patients, physicians, families, and co‑workers using a customer‑service focus and positive language.
• Excellent telephone and in‑person communication and interpersonal skills.
• Proficiency in medical terminology, including diagnoses, operative procedures, and CPT codes.
• Strong spelling and grammar abilities.
• Working knowledge of a PC environment (Windows, word processing, basic Excel) and ability to enter data via keyboard throughout the shift.
• Capability to navigate multiple applications and websites related to registration simultaneously.
• Managed‑care knowledge with ability to differentiate insurance plans (PPO, POS, HMO, etc.).

Essential Functions

People Essential Functions

• Use critical thinking and healthcare knowledge to manage primary, specialty, and ancillary scheduling processes.
• Exercise independent judgment to accommodate special requests from internal and external customers.
• Serve as the “front door” for new and established patients, providing information needed to schedule and register multiple services.
• Utilize computerized scheduling, registration, verification systems, and online applications while balancing departmental resources.
• Obtain required data to support departmental and hospital clinical/financial needs.
• Triaging calls for the System Patient Access Center according to management guidelines and scripts.
• Provide patients with preparation information per Center/Service protocol and encourage enrollment in the Patient Portal, complying with HIPAA regulations.
• 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

• Employ courteous telephone techniques and interpersonal skills to establish rapport while maintaining patient confidentiality.
• Follow department scripting and appointment‑scheduling policy, ensuring ICARE values are met.
• Assist with new referrals received via e‑fax, email, or direct calls for emergency appointments.
• Collect and compile patient data (insurance documentation, identification) to facilitate appointments.
• Screen and assess patient calls, ensuring scheduling aligns with referring physician orders or patient requests.
• Schedule appointments, complete registration efficiently, and answer incoming patient calls.
• Act as liaison between patients and physicians/clinical staff, maintaining relationships and obtaining necessary documents.
• Resolve patient issues using exceptional telephone, verbal, written, critical‑thinking, and interpersonal communication skills.

Quality/Safety Essential Functions

• Adhere to scheduling processes and workflows within the electronic medical record while maintaining privacy and HIPAA compliance.
• Meet productivity standards and scheduling goals (e.g., abandonment rate, productivity per hour).
• Verify patient insurance and ensure eligibility procedures are completed prior to visits.
• Provide patients with appointment preparation information per Center/Service protocol.

Finance Essential Functions

• Partner with the revenue‑cycle team to ensure accurate registration and financial clearance before patient visits.
• Enter precise scheduling and registration data (demographics, insurance, guarantor, clinical information) to initiate benefit eligibility, pre‑certification, and payment review.
• Document potential issues that could cause service delays or cancellations due to lack of financial clearance.

Growth/Innovation Essential Functions

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

Supplemental Requirements

• Work Attire: Uniform – No; Business professional – Yes; Other (department approved) – No.
• On‑Call: Employees may be required to be on‑call during emergencies (e.g., disaster, severe weather).
• Travel: May require travel within the Houston Metropolitan area; travel outside the Houston Metropolitan area is not required.