Senior Patient Access Specialist

Ensemble Health Partners · Phoenixville, PA · 3 wk ago

Healthcare$18.65–$19.9/hrFull-time

Career Opportunity Offering

Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement

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

Job Description

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.

Essential Job Functions

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. Adhere to Ensemble Health Partners policies and provide excellent customer service in these interactions with the appropriate level of compassion.
Operates the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
Patient Access staff are responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities.
A Senior Patient Access Specialist is responsible for the development of 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.
A Senior Patient Access Specialist is responsible for the development of staff schedules within the patient access department.
A Senior Patient Access Specialist will have on-call responsibilities for the department, including providing after-hours support and guidance.
Senior Patient Access Specialists are responsible for the collection of point of service payments. These activities may be conducted in emergency, outpatient, and inpatient situations including past due balances and offering payment plan options.
The Patient Access Specialist is expected to adhere to Ensemble Health Partners policies and provide excellent customer service in these interactions.
Conducts audits of accounts and assures that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access Leadership.
A Senior Patient Access Specialist will be held accountable for point of service goals as assigned.
Explains general consent for treatment forms to the patient/guarantor/legal guardian, obtains necessary signatures and witness’s name.
Explains and distributes patient education documents, such as Important Message from Medicare, Observation Forms, Consent forms, and all forms implemented for future services.
Reviews eligibility responses in insurance verification system and appropriately selects the applicable insurance plan code, enters benefit data into system to support POS (Point of Service 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.
Responsible for accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate.
Responsible for distribution and documentation of other designated forms and pamphlets.

Job Experience

1 to 3 Years

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.

Education Level

Associate degree or Equivalent Experience

Other Preferred 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.