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. They must adhere to Ensemble Health Partners policies and provide 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.
- Develop training materials and programs for new hires and provide continuing education to associates.
- Develop staff schedules within the patient access department.
- Provide on-call support for the department, including working unscheduled times to cover staffing issues.
- 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, obtain necessary signatures, and distribute patient education documents.
- Review eligibility responses in insurance verification systems and enter benefit data into the system.
- Screens medical necessity using the Advanced Beneficiary Notice (ABN) software and distribute the ABN as appropriate.
- Accurately screen medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of tests by Medicare and distribute the ABN as appropriate.
- Distribute and document other designated forms and pamphlets.
Requirements
The ideal candidate has 1 to 3 years of experience in a similar role, an associate degree or equivalent, and a comprehensive knowledge of patient insurance processes, including obtaining authorizations and benefits verification. They must also have knowledge of health insurance requirements and medical terminology or CPT/procedure codes.
Qualifications
Open to candidates with a bachelor's degree or higher, and a willingness to learn and embrace innovation, including AI, to improve patient and client experiences.
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, inquisitive nature, and openness to innovation.
Benefits
Comprehensive benefits package including healthcare, time off, retirement, and well-being programs. Growth opportunities through professional certifications and tuition reimbursement. Recognition through quarterly and annual incentive programs.
Pay
$18.65 - $19.90/hr based on experience.
Schedule
Flexible schedule to accommodate the needs of the position and the team.