Patient Access Service Representative

BRENDA W. MERRITT

PROFESSIONAL EXPERIENCE

VILLAGE MEDICAL CLINIC, Houston, TX August 2022 - December 2022, March 2023 - March 2024

Patient Access/Referral Specialist (Contract) (March 2023 - March 2024)

Assisted patients with check-out following their appointments and scheduled follow-up appointments as ordered by the provider

Verified patient's insurance before the day of their upcoming appointment

Received incoming calls from patient's inquiries, complaints, and pharmacies directing them to the proper department or appropriate medical staff member

Verified insurance eligibility for referred services using databases and contacted insurers

Performed quality assurance checks on completed referrals before submitting them for approval

Prioritized referrals according to urgency and reviewed all documentation of each referral to ensure the office accepted the insurance

Patient Access Service Representative (Contract) (August 2022 - December 2022)

Checked in patients upon arrival in the facility, notifying clinical staff of any late arrivals, or no-shows and rescheduled as needed

Verified accurate demographics and insurance along with cashiering functions, required copay, deductible, explaining consent forms, obtained signatures in accordance with the established policies and procedures

Assisted patients with understanding their financial responsibilities of past due balances in a professional manner

Scheduled follow-up appointments if needed at check-out and ensured that their appointment would be received in their portal or given to them manually

Assisted team members whenever short staff or as needed

HOUSTON METHODIST HOSPITAL/WILLOWBROOK, Houston, TX October 2015 - April 2019

Patient Access Representative Call Center

Responsible for coordinating, scheduling, and registering patients for all the Methodist Primary Care Group

Utilized a computerized system and multiple software applications to complete the registration process including software management that supports eligibility and verification

Received, screened, and processed a high volume of calls for emergent reasoning that would be directed to triage nurses

Utilized courteous and professional telephone techniques to establish and maintain rapport with patients while maintaining patient confidentiality

Verified patient demographics and eligibility as guided by scheduling protocol for each physician as needed to coordinate care and participated in weekly huddles with team members to discuss goals and objectives

TEXAS CHILDREN’S PEDIATRICS ASSOCIATE, Houston, TX July 2002 - June 2015

Senior Patient Service Representative

Provided overall scheduling registration of daily operations for Texas Children’s Pediatrics in a fast-paced call center via epic registered scheduling system

Assisted with the registration of new and existing patients by collecting demographic information and insurance information

Applied HIPAA guidelines when handling confidential information related to patient information

Monitored emergent calls that were too escalated to the triage nurse after following the outlined protocol

Assisted with training new staff members on the registration process in the after-hour clinic when hired for the call center

Monitored incoming calls and portal messages for quality assurance purposes

Assisted the referral coordinator with pre-authorizations and new referrals when emergent situations were needed by the physician

EDUCATION

ALVIN COMMUNITY COLLEGE, Alvin, TX

General Studies

TECHNICAL SKILLS

Microsoft Office Word and Excel, Epic Practice Management, and Athena

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