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
- Assign accurate MRNs
- Complete medical necessity/compliance checks
- Provide proper patient instructions
- Collect insurance information
- Receive and process physician orders
- 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 these interactions with the appropriate level of compassion
- Be held accountable for point of service goals as assigned
- Perform pre-registration of patient accounts before patient visits, including 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 and obtain necessary signatures and the 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 the insurance verification system and appropriately select the applicable insurance plan code, enter benefit data into the system to support (POS) Point of Service Collections and billing processes to assist with a clean claim rate
- Accurately screen medical necessity using the Advance Beneficiary Notice (ABN) software to inform Medicare patients of potential non-payment of tests by Medicare and distribute the ABN as appropriate
- Distribute and document other designated forms and pamphlets
- Utilize quality auditing and reporting systems to ensure accounts are corrected; conduct audits of accounts and assure that all forms are completed accurately and on time to meet audit standards and provide statistical data to Patient Access leadership
Requirements
- High School Diploma/GED required
- CRCR Certification (Certified Revenue Cycle Representative) required within 6 months of hire (company paid)
Skills
- 1+ years of customer service experience
- Inquisitive and demonstrates openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences