Patient Access Associate Specialist

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 recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!

O.N.E Purpose:

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
• Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

Responsibilities

The Patient Access Associate Specialist plays a critical role in ensuring a seamless and positive patient experience by accurately managing patient registration and access processes within the healthcare revenue cycle. This role ensures data integrity, regulatory compliance, and a positive patient experience while directly influencing revenue cycle KPIs such as registration accuracy, point-of-service collections, and first-pass claim rates. Serves as the first point of contact for patients onsite in healthcare facilities and are essential in supporting clinical and financial operations for financial health through accurate data entry, auditing, and communication.

• 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 as applicable.
• Adhere to policies and provide excellent customer service in interactions with the appropriate level of compassion.
• Be held accountable for point of service goals as assigned.
• Utilize quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities. Conduct audits of accounts and assure that 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. This may include inbound and outbound calling to obtain demographic, insurance, and other patient information including patient financial liabilities, collecting point of service collections as well as past due balances including payment plan options.
• Explain general consent for treatment forms to the patient/guarantor/legal guardian, obtain necessary signatures and witness’s name. 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 insurance verification system and appropriately select the applicable insurance plan code, enter benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.
• Accurately screen medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribute the ABN as appropriate. Responsible for distribution and documentation of 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/GED Required

Qualifications

• CRCR certification required within 6 months of hire (Company Paid)

Benefits

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement

Pay

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

Schedule

This position is on-site, and candidates must be able to work on-site at Ballad - Smyth County Community Hospital, Marion, VA.