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 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 in emergency, outpatient, and inpatient situations, 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, entering benefit data into the system to support POS 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, 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, medical terminology or CPT/procedure codes, and be inquisitive and open to innovation.

Qualifications

Essential qualifications include adherence to Ensemble Health Partners' policies, excellent customer service, and the ability to work independently and as part of a team. Applicants must also be able to operate a telephone switchboard and utilize quality auditing and reporting systems.

Skills

The Senior Patient Access Specialist should possess a strong understanding of the revenue cycle, including admission, billing, payments, and denials. They must be knowledgeable about Health Insurance requirements and medical terminology or CPT/procedure codes. Additionally, they should be inquisitive and open to exploring innovative processes and improving patient and client experiences through AI and other technologies.

Benefits

Ensemble offers a comprehensive benefits package, including healthcare, time off, retirement, and well-being programs. The company also provides professional certifications, tuition reimbursement, quarterly and annual incentive programs, and recognition for excellence. Ensemble is committed to creating a supportive and inclusive workplace culture, and they are an equal opportunity employer.