Patient Access Specialist (Day Shift)

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.

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 and complete medical necessity / compliance checks.
• Provide proper patient instructions and collect insurance information.
• Receive and process physician orders while utilizing an overlay tool.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls.
• Adhere to policies and provide excellent customer service with compassion.
• Meet point of service goals as assigned.
• Utilize quality auditing and reporting systems to ensure accounts are corrected, including audits for other employees, departments, and facilities.
• Conduct audits of accounts to ensure 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, including inbound and outbound calling to obtain demographic, insurance, and other patient information, including point of service collections and past due balances.
• 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 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 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.

Experience We Love

• 1+ years of customer service experience.
• Inquisitive and open 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).

Join An Award-winning Company

• 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.

Benefits

• Comprehensive benefits package designed to support physical, emotional, and financial health, including healthcare, time off, retirement, and well-being programs.
• Professional development: each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition: quarterly and annual incentive programs for employees who go beyond and keep raising the bar.