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.
• 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 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, obtain necessary signatures, and distribute patient education documents.
• Review eligibility responses in insurance verification systems and appropriately select insurance plan codes.
• Screen medical necessity using the Advanced Beneficiary Notice (ABN) software and distribute ABNs as appropriate.
• Audit and document other designated forms and pamphlets.

Requirements

The ideal candidate must have 1 to 3 years of experience in a similar role, an associate degree or equivalent, and a comprehensive understanding of the patient insurance process, including obtaining authorizations and benefits verification. Knowledge of health insurance requirements and medical terminology or CPT/procedure codes is essential. Candidates must be inquisitive and open to innovation, including AI, to explore better processes and improve patient and client experiences.

Qualifications

Qualified candidates must possess excellent communication and customer service skills, as well as the ability to work independently and manage multiple tasks simultaneously. Proficiency in Microsoft Office and familiarity with revenue cycle management systems are preferred.

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.
• Ability to operate an overlay tool and utilize quality auditing and reporting systems.
• Inquisitiveness and openness to innovation, including AI.

Benefits

Ensemble offers a comprehensive benefits package, including healthcare, time off, retirement, and well-being programs. The company is also recognized as an award-winning employer, with multiple recognitions for its commitment to excellence in revenue cycle management and employee well-being.

Pay

The Senior Patient Access Specialist at Ensemble Health Partners is paid between $18.65 - $19.90 per hour, based on experience.

Schedule

The Senior Patient Access Specialist works within the policies and processes of Ensemble Health Partners and adheres to all regulatory compliance requirements.