Patient Access Specialist

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.

About the role

This entry-level position is responsible for performing admitting duties for all patients admitted for services at the hospital while meeting the mission and goals of the organization and all regulatory compliance requirements. The Representative will work within established policies and processes across the entire organization.

Responsibilities

• Assign accurate Medical Record Numbers (MRNs), complete medical necessity and compliance checks, provide proper patient instructions, collect insurance information, receive and process physician orders, and utilize overlay tools while delivering excellent customer service as measured by Press Ganey.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls, adhering to policies and providing compassionate customer service. Meet point-of-service goals as assigned.
• Utilize quality auditing and reporting systems to correct accounts, including those for other employees, departments, and facilities. Conduct audits to ensure forms are completed accurately and timely, meeting audit standards, and provide statistical data to Patient Access leadership.
• Pre-register patient accounts prior to visits, including inbound and outbound calls to obtain demographic, insurance, and financial information. Collect point-of-service payments, past due balances, and set up payment plans.
• Explain general consent for treatment forms to patients, guarantors, or legal guardians, obtain necessary signatures, and witness names.
• Distribute and explain patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and other relevant materials.
• Review eligibility responses in the insurance verification system, select applicable insurance plan codes, and enter benefit data to support point-of-service collections and billing processes for a clean claim rate.
• Accurately screen medical necessity using Advanced Beneficiary Notice (ABN) software to inform Medicare patients of potential non-payment and distribute ABNs as appropriate. Distribute and document other designated forms and pamphlets.

Requirements

• 1+ years of customer service experience.
• Inquisitive mindset with openness to innovation, including AI, to improve processes and enhance patient and client experiences.
• High School Diploma or GED.
• CRCR certification required within 6 months of hire (company-paid).

Benefits

• Bonus incentives.
• Paid certifications.
• Tuition reimbursement.
• Comprehensive benefits package supporting physical, emotional, and financial health, including healthcare, time off, retirement, and well-being programs.
• Collaborative and innovative culture focused on growth and recognition.
• Quarterly and annual incentive programs for high performers.

Pay

$17.00 - $18.15 per hour, based on experience.

Schedule

This is an onsite role. Candidates must be able to work on-site at Ballad - Lonesome Pine in Big Stone Gap, VA.

Ensemble is an equal employment opportunity employer and provides reasonable accommodations to qualified individuals with disabilities. If you require accommodation in the application process, please contact TA@ensemblehp.com.