Senior Patient Access Specialist

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.

Responsibilities

• Performing admitting duties for all patients admitted for services at the hospital.
• Assigning accurate MRNs, completing medical necessity/compliance checks, providing proper patient instructions, collecting insurance information, receiving and processing physician orders, and utilizing a overlay tool while providing excellent customer service as measured by Press Ganey.
• Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
• Conducting audits of accounts and ensuring that all forms are completed accurately, timely to meet audit standards and providing statistical data to Patient Access leadership.
• Pre-registering patient accounts prior to patient visits, which may include inbound and outbound calling to obtain demographic, insurance, and other patient information including the patient financial liabilities including collecting point of service collections as well as past due balances including payment plan options.
• Explaining general consent for treatment forms to the patient/guarantor/legal guardian, obtaining necessary signatures and witnesses name. Explaining and distributing patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.
• Reviewing eligibility responses in insurance verification system and appropriately selecting the applicable insurance plan code, entering benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.
• Screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of tests by Medicare and distributing the ABN as appropriate.
• Distributing and documenting other designated forms and pamphlets.

Requirements

Employment Qualifications:

• Certified Healthcare Access Associate (CHAA) and/or Certified Revenue Cycle Representative (CRRC), (Company Paid).

Other Preferred Knowledge, Skills, and Abilities:

• 2 Year/Associates Degree preferred, Specialty/Major: Healthcare administration, business administration, or related field.
• Minimum 2-3 years of experience in patient access or leadership role.
• 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.

Qualifications

Minimum Qualifications:

• High School Diploma or equivalent.
• Completion of a healthcare access program or equivalent.

Preferred Qualifications:

• 2 Year/Associates Degree preferred, Specialty/Major: Healthcare administration, business administration, or related field.
• Minimum 2-3 years of experience in patient access or leadership role.

Skills

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.
• Inquisitive and open to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

Benefits

This position pays between $18.65 - $19.90/hr. based on experience. This position is an onsite role at Mercy - Perrysburg Medical Center in Perrysburg, OH. The schedule is Full Time First Shift.

Pay

This position pays between $18.65 - $19.90/hr. based on experience.

Schedule

This position is an onsite role at Mercy - Perrysburg Medical Center in Perrysburg, OH. The schedule is Full Time First Shift.

Benefits

Employer provided benefits include:

• 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.
• Our culture is rooted in collaboration, growth, and innovation.
• We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Equal Opportunity Employer

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories. Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.