Patient Access Associate Specialist

The Opportunity

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.

Job Responsibilities

• Patient Access Associate Specialist are responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders, and utilizing an overlay tool while providing excellent customer service as measured by Press Ganey.
• Operates 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.
• Responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities.
• Conducts audits of accounts and assures that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access leadership.
• Responsible for the pre-registration of patient accounts prior to patient visits. This may include inbound and outbound calling to obtain demographic, insurance, and other patient information including the patient financial liabilities including collecting point of service collections as well as past due balances including payment plan options.
• The Patient Access Associate Specialist explains general consent for treatment forms to the patient/guarantor/legal guardian, obtains necessary signatures and witness’s name. Explains and distributes 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.
• Reviews eligibility responses in insurance verification system and appropriately selects the applicable insurance plan code, enters benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.
• Responsible for accurately screening medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate. Responsible for distribution and documentation of other designated forms and pamphlets.

Required Experience

• 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.

Minimum Education

A High School Diploma/GED is required.

Required Certifications

• CRCR

Benefits

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Innovation & Work-Life Flexibility

We believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Inclusion & Diversity

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories. Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.