Senior Patient Access Specialist

About the role

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.

Responsibilities

• Patient Access staff are responsible for assigning accurate MRNs, completing medical necessity or compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician order while utilizing an overlay tool and providing excellent customer service as measured by Press Ganey.
• Serve as the SMART for the department.
• Utilize quality auditing and reporting systems to ensure accounts are corrected.
• Develop training materials and programs for new hires to the department, as well as providing continuing education to associates in all areas of the revenue cycle.
• Develop staff schedules within the patient access department.
• Provide after-hours support and guidance for the department.
• 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, timely to meet audit standards and provide statistical data to Patient Access Leadership.
• Explain general consent for treatment forms to the patient/guarantor/legal guardian, obtain necessary signatures and witness’s name.
• Distribute and document patient education documents such as Important Message from Medicare, Observation Forms, Consent forms, and all forms implemented for future services.
• 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.
• May be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Requirements

Job Experience: 1 to 3 Years
Education Level: Associate degree or Equivalent

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.

Qualifications

Knowledge of medical terminology or CPT or procedure codes.

Benefits

Comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.