Associate Specialist, Patient Access

About the role

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy.

We are searching for the next Patient Access Specialist champion. This role is responsible for performing admitting duties for all patients admitted for services at the hospital, meeting the mission and goals of the organization and all regulatory compliance requirements while working within established policies and processes across the entire organization.

Responsibilities

• Assign accurate MRNs, complete medical necessity/compliance checks, provide proper patient instructions, collect insurance information, receive and process physician orders, and utilize an overlay tool while providing excellent customer service as measured by Press Ganey.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls; adhere to policies and provide excellent customer service with appropriate compassion.
• Meet assigned point-of-service goals.
• Utilize quality auditing and reporting systems to ensure accounts are corrected, including accounts for other employees, departments, and facilities; conduct audits of accounts, assure all forms are completed accurately and timely to meet audit standards, and provide statistical data to Patient Access leadership.
• Pre-register patient accounts prior to patient visits, including inbound and outbound calling to obtain demographic, insurance, and other patient information, patient financial liabilities, point-of-service collections, past-due balances, and payment plan options.
• Explain general consent for treatment forms to the patient/guarantor/legal guardian, obtain necessary signatures, and witness names.
• Explain and distribute patient education documents such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.
• Review eligibility responses in the insurance verification system, appropriately select applicable insurance plan codes, enter benefit data into the system to support point-of-service collections and billing processes to assist with a clean claim rate.
• Accurately screen medical necessity using Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of tests by Medicare and distribute the ABN as appropriate; distribute and document other designated forms and pamphlets.

Requirements

• 1+ years of customer service experience
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences
• High School Diploma or GED
• CRCR certification required within 9 months of hire (company paid)

Benefits

• Bonus incentives
• Paid certifications
• Tuition reimbursement
• Comprehensive benefits package supporting physical, emotional, and financial health (healthcare, time off, retirement, well-being programs)
• Career advancement opportunities
• Shift differential for select shifts
• Quarterly and annual incentive programs
• Professional certification relevant to field

Pay

This position pays between $17.00 - $18.15/hr based on experience.

Schedule

This is an onsite role; candidates must be able to work on-site at Benefis - East Campus in Great Falls, MT. Shift differential offered for select shifts.