Senior Patient Access Specialist

About the role

The Senior Patient Access Specialist at Ensemble Health Partners is responsible for performing admitting duties for all patients receiving services, including training, scheduling, and other senior-level responsibilities. This role adheres to Ensemble Health Partners' policies and provides excellent customer service.

Responsibilities

• Assign accurate MRNs, complete medical necessity or compliance checks, provide patient instructions, collect insurance information, receive, and process physician orders, and utilize an overlay tool.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls.
• Utilize quality auditing and reporting systems to ensure accounts are corrected, including accounts for other employees, departments, and facilities.
• Develop training materials and programs for new hires and provide continuing education to associates in all areas of the revenue cycle.
• Develop staff schedules within the patient access department.
• Provide on-call support for the department, including after-hours support and guidance.
• Collect point of service payments, including past due balances and offering payment plan options.
• Conduct audits of accounts and provide statistical data to Patient Access Leadership.
• Explain general consent for treatment forms to patients/guarantors/legal guardians, obtain necessary signatures, and distribute patient education documents.
• Review eligibility responses in insurance verification systems and appropriately select the applicable insurance plan code, enter benefit data into the system, and support POS (Point of Service Collections) and billing processes.
• Screen medical necessity using the Advanced Beneficiary Notice (ABN) software and distribute and document other designated forms and pamphlets.

Requirements

The ideal candidate must have 1 to 3 years of experience in a similar role. Comprehensive knowledge of patient insurance processes, including obtaining authorizations and benefits verification, is essential. Understanding of medical terminology or CPT/procedure codes is also required. Must be inquisitive and open to innovation, including AI, to explore better processes and improve patient and client experiences.

Qualifications

A college degree or equivalent experience is preferred. Must possess a valid driver's license and reliable transportation. Must be able to lift up to 25 pounds and stand for extended periods.

Skills

• Understanding of Revenue Cycle including admission, billing, payments, and denials.
• Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification.
• Knowledge of Health Insurance requirements.
• Knowledge of medical terminology or CPT or procedure codes.
• Understanding of AI and its potential to improve processes and experiences.

Benefits

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement

Pay

This position pays between $18.65 - $19.90/hr based on experience.

Schedule

Flexible schedule to accommodate the needs of the role and the team.