Patient Access Associate Specialist
About the role
This is an entry-level career opportunity for a Patient Access Specialist champion. This role is responsible for performing admitting duties for all patients admitted for services at the hospital. They are responsible for performing these functions while meeting the mission and goals of the organization and all regulatory compliance requirements. The Representative will work within the policies and processes as they are being performed 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 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.
- 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 the patient financial liabilities, including 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 for 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.
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.
- Minimum Education: High School Diploma/GED
- Required Certifications: CRCR Required within 9 months of hire (Company Paid)
Benefits
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
- 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.
Pay
This position pays between $17.00 - $18.15 based on experience.
Schedule
Full Time 5:30am-4pm (weekend, holiday rotation required)
This position is an onsite role at Mercy - St Anne Hospital in Toledo, OH.
About Ensemble
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.
About the company's recognition
- Five-time winner of "Best in KLAS" 2020-2022, 2024-2025
- Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
- 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
- Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
- Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
- Energage Top Workplaces USA 2022-2024
- Fortune Media Best Workplaces in Healthcare 2024
- Monster Top Workplace for Remote Work 2024
- Great Place to Work certified 2023-2024