Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.
Primary Purpose
The Member Access Representative is at the forefront of creating exceptional patient
experiences and health outcomes that lead to happier, healthier, and more engaged members
and their eligible dependents. As a key contributor of the clinic team, the Member Access
Representative is accountable for providing first contact resolution to all care access needs,
such as appointment scheduling, referrals, clinical message requests, health information
documentation, financial assistance, and customer service.
Education
• Must have completed training through an accredited Medical Assistant training program or
obtain training within 18 months of hire date.
• Must have a High School diploma or GED.
Experience
• Must have three (3) years of medical office, business office, call center or customer service
experience.
• Patient registration and appointment scheduling experience preferred.
Certification/Registration/Licensure
• Medical Terminology Course Certificate and/or Medical Assistant Certification preferred.
Skills or Special Abilities
• Must be able to work collaboratively with colleagues to deliver patient/customer services that
exceeds patient expectations as evidenced by patient satisfaction scores.
• Must be able to communicate effectively with all hospital personnel, patients and visitors.
• Must be detail oriented and have sharp analytical skills to resolve access issues as related to
multiple groups including third-party payors, physicians, patients and the system.
• Must be able to demonstrate competency required as applicable to specialty area.
• Must have familiarity with diagnostic ICD-10 CM coding and HCPCS-CPT4 procedure codes.
• Must have working knowledge of medical terminology.
• Must be able to demonstrate basic clerical skills and working knowledge of standard office
equipment.
• Must be able to solve problems within the guidelines of established policies and procedures.
• Must demonstrate a positive demeanor, good verbal and written communication skills, and a
professional appearance and approach.
• Must be able to adjust to multiple demands, shifting priorities and rapid change.
• Bilingual skills preferred.
Responsibilities
1. Assists patients with complex scheduling needs to ensure appointments are scheduled as
expeditiously as possible. Ensures referral is approved prior to scheduling, if referral required.
Reviews specialty clinic referral note for scheduling instructions. Ensures appointment notes
are clear and concise. Demonstrates knowledge of clinic scheduling rules and pre-clinical
requirements for each clinical area. Contacts medical provider or clinical area, as needed, for
clarification.
2. Places patient on the recall or wait list when appointments are not available. Communicates
patient’s options for health care while on the recall/wait list. Works recall or wait lists
contacting patients for appointment scheduling, as assigned.
3. Gathers, verifies and documents data elements including patient demographics and funding
information to ensure that patient information is complete and accurate prior to the date of
service. Performs a thorough search prior to creating a new medical record number to prevent
duplicate medical record numbers. Updates demographics as needed.
4. Communicates to the patient the patient’s financial responsibility including co-payments and
fees for each clinical area based on financial classification and whether an authorized referral
is required for service. Reviews the patient account to determine whether patient is funded or
not. Completes benefit verification function prior to scheduling as required by financial
classification. Verifies assigned Primary Care Physician per managed care plan. Educates
patient on financial assistance process. Refers non-funded patients to financial counseling.
5. Enters referrals on-line, as assigned, with 3% or less error rate. Assists other Member Access
Representatives with more difficult referral entries. Obtains clinical assistance as needed for
issues identified on referrals. Pends referrals based on financial classification to appropriate
staff for clinical and financial clearance as required. Obtains clinical and financial data for
outside provider referrals to Parkland and communicates information to appropriate staff for
disposition. Manages clinical denials of referrals. Ensures referral documentation is clear and
concise.
6. Identifies need for a telephone encounter during patient call. Reviews past/current encounters
to prevent duplication. Completes addendums as needed. Documents necessary information
(signs/symptoms, medication name, contact information, etc.). Routes telephone encounters
appropriately.
7. Maintains a positive working relationship and effective communication with patients, health
care providers, clinic personnel, management and other employees to ensure interactions are
professional in manner and promotes a positive image for Parkland.
8. Supports all clerical, health information documentation, and other business operations tasks
as assigned by management.
9. Works scheduling and denial work queues between calls and as assigned contacting patients
for scheduling and notifying referring provider for denials. Enters data into Access database
as required. Completes special projects as assigned by management.
10. Serves as a resource for training staff in the area. May serve in a leadership role on
department committees/projects.
11. Telehealth - Provide education to patients/caregivers on how to properly connect for virtual
services
12. Telehealth - Directly engage patient to assess telehealth experience and feedback
Job Accountabilities
1. Identifies ways to improve work processes and improve customer satisfaction. Makes
recommendations to supervisor, implements, and monitors results as appropriate in
support of the overall goals of the department and Parkland.
2. Stays abreast of the latest developments, advancements, and trends in the field by
attending seminars/workshops, reading professional journals, actively participating in
professional organizations, and/or maintaining certification or licensure. Integrates
knowledge gained into current work practices.
3. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that
impact the area. Develops effective internal controls designed to promote adherence with
applicable laws, accreditation agency requirements, and federal, state, and private health
plans. Seeks advice and guidance as needed to ensure proper understanding.
Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status. As part of our commitment to our patients and employees’ wellness, Parkland Health is a tobacco and smoke-free campus.
