Senior Patient Access Specialist
Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy.
About the role
The Senior Patient Access Specialist is responsible for performing admitting duties for all patients admitted for services at the hospital. They are responsible for performing these functions while meeting the mission and goals of the organization and all regulatory compliance requirements. The Representative will work within the policies and processes as they are being performed across the entire organization.
- Assign accurate MRNs, complete medical necessity/compliance checks, provide proper patient instructions, collect insurance information, receive and process physician orders, and utilize an overlay tool while providing excellent customer service as measured by Press Ganey.
- Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable, adhering to policies and providing excellent customer service.
- Conduct quality audits and reporting to ensure accounts are corrected, including accounts for other employees, departments, and facilities.
- Pre-register patient accounts prior to visits, including inbound and outbound calling to obtain demographic, insurance, and financial information, and collect point-of-service payments and past-due balances.
- Explain and obtain signatures for general consent for treatment forms, distribute patient education documents (e.g., Important Message from Medicare, MOON form, consent forms).
- Review eligibility responses in the insurance verification system, select applicable insurance plan codes, and enter benefit data to support point-of-service collections and billing processes.
- Screen for medical necessity using Advanced Beneficiary Notice (ABN) software, inform Medicare patients of potential non-payment, and distribute ABNs as appropriate.
- Distribute and document other designated forms and pamphlets.
- Meet point-of-service goals as assigned.
Requirements
- Certified Healthcare Access Associate (CHAA) and/or CRCR (Certified Revenue Cycle Representative) – company paid.
- 2–3 years of experience in patient access or a leadership role.
- Understanding of revenue cycle, including admission, billing, payments, and denials.
- Comprehensive knowledge of patient insurance processes, including authorizations and benefits verification.
- Knowledge of health insurance requirements and medical terminology, CPT, or procedure codes.
- Openness to innovation, including AI, to improve processes and patient/client experiences.
Qualifications
- Preferred: 2-year/Associate Degree in Healthcare Administration, Business Administration, or related field.
Benefits
- Bonus incentives
- Paid certifications
- Tuition reimbursement
- Comprehensive benefits package (healthcare, time off, retirement, well-being programs)
- Career advancement opportunities
- Professional development and certification support
- Quarterly and annual incentive programs
- Work-life flexibility and recognition programs
Pay
$18.65 - $19.90/hour, based on experience.
Schedule
This is an onsite role at Mercy - Fairfield Hospital in Fairfield, OH.
Ensemble is an award-winning company, recognized as a five-time winner of “Best in KLAS” (2020–2022, 2024–2025), Black Book Research's Top Revenue Cycle Management Outsourcing Solution (2021–2024), and recipient of 22 HFMA MAP Awards for High Performance in Revenue Cycle (2019–2024), among other accolades.