Senior Patient Access Specialist

About the Opportunity

This position pays between $18.65 - $19.90/hr based on experience. This position is an onsite role, and candidates must be able to work on-site at Carillion-Rockbridge Hospital in Lexington, VA.

What We Offer

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

Role Overview

The Senior Patient Access Specialist is responsible for performing admitting duties for all patients receiving services at Ensemble Health Partners. Additional duties can include training, scheduling, and other senior-level responsibilities. They are responsible for performing these functions while meeting the mission of Ensemble Health Partners and all regulatory compliance requirements. The Senior Patient Access Specialist will work within the policies and processes that are being performed across the entire organization.

Responsibilities

• Assign accurate MRNs, complete medical necessity or compliance checks, provide proper patient instructions, collect insurance information, receive and process physician orders while utilizing an overlay tool and providing excellent customer service as measured by Press Ganey.
• Serve as the SMART for the department.
• Adhere to Ensemble Health Partners policies and provide excellent customer service in these interactions with the appropriate level of compassion.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
• 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, as well as provide continuing education to associates in all areas of the revenue cycle.
• Develop staff schedules within the patient access department.
• Perform on-call responsibilities for the department, including providing after-hours support and guidance. May be responsible for working unscheduled times to cover staffing issues.
• 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 assure that all forms are completed accurately and timely to meet audit standards, providing statistical data to Patient Access Leadership.
• Be held accountable for point of service goals as assigned.
• 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, Observation Forms, Consent forms, and all forms implemented for future services.
• Review eligibility responses in insurance verification system and appropriately select the applicable insurance plan code, enter benefit data into system to support POS Collections and billing processes to assist with a clean claim rate, including pre-registration of patient accounts prior to the patient visit which may include inbound and outbound calls to obtain demographic information, insurance information, and all other patient information.
• 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.
• Associates may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Experience & Education

• 1 to 3 Years of experience
• Associate degree or Equivalent Experience

Required Knowledge, Skills, and Abilities

• 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.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.