For many years, patient access job descriptions did not change much, if at all, at Houston-based Harris Health System. Today, staff review these descriptions annually and update as needed, thanks to the fast-changing role of patient access.
“We want to make sure that we aren’t missing out on high-quality talent because our job descriptions are outdated,” says Pollie Martinez, RN, director of operations for patient access. This year, two new skills were added: customer service and insurance verification. “Providing exceptional customer service is the number one priority of the patient access representatives,” Martinez explains.
Regarding customer service, the job requirements now read in part: “Consistently supports the hospital’s customer satisfaction standards, the mission, vision, and values of Harris Health System.”
A patient access worker is the first person most people interact with. “By making the patient feel welcome, we have the ability to set the tone for the visit,” Martinez says. Registrars greet patients by saying, “Welcome to Harris Health. How may I assist you today?” or “Good morning/good afternoon. How may I assist you today?”
As for insurance verification, it is increasingly important to ensure “clean” claims go out, preventing denials. “Patient access must ensure all accounts contain comprehensive and accurate data,” Martinez notes. “This provides for timely billing and optimal reimbursement.”
Regarding insurance verification, Harris Health asks prospective patient access employees that they must notify patients about third-party payer referral requirements, insurance benefits, and patient liability. In addition, employees are asked to discuss, secure, and document commitment for patient’s payment for treatment, including payment options for deductibles, copays, or estimated full fees, if appropriate.
Because Harris Health is a safety net system, it is vital employees understand insurance. “With the introduction of ACA Marketplace insurance, patient access staff have been providing information about enrollment over the last several years,” Martinez says, noting many of the health system’s patients have insurance for the first time in their lives.
“Since it is new, they have a lot of questions. We must be able to assist and educate them,” Martinez adds.
Applicants are screened carefully to be sure they are equipped with the newly required skill sets.
“Only those who meet the prerequisites are forwarded to the management team to review for possible interviews,” Martinez notes.
Expectations continue to evolve in the fast-changing field. Harris Health employs coding and authorization teams, but these skills are becoming far more important for patient access. “There is not an immediate need to add these to the job descriptions, but if prospective employees do have this experience, it is a bonus,” Martinez says.