Senior Patient Access Specialist
About the role
The Senior Patient Access Specialist at Ensemble Health Partners is responsible for performing admitting duties for all patients receiving services, including patient instructions, insurance information collection, and claims processing. This role also involves training, scheduling, and other senior-level responsibilities.
Responsibilities
- Assign accurate MRNs, complete medical necessity or compliance checks, and provide patient instructions.
- Collect insurance information, receive, and process physician orders, and utilize an overlay tool.
- Operate the telephone switchboard to relay calls and ensure accounts are corrected through quality auditing and reporting systems.
- Develop and provide training materials and programs for new hires and continuing education to associates.
- Develop and manage staff schedules within the patient access department.
- Provide on-call support for the department, including after-hours coverage and working unscheduled shifts to address staffing issues.
- Collect point of service payments, including past due balances and payment plan options.
- Audit accounts and provide statistical data to Patient Access Leadership.
- Explain general consent forms to patients/guarantors/legal guardians, obtain necessary signatures, and distribute patient education documents.
- Screen medical necessity using the Advanced Beneficiary Notice (ABN) software and distribute other designated forms and pamphlets.
Requirements
The ideal candidate for this role has 1 to 3 years of experience in a similar position, an associate degree or equivalent, and a comprehensive knowledge of patient insurance processes and medical terminology. They must also have a strong understanding of the revenue cycle, including admission, billing, payments, and denials.
Qualifications
- 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.
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.
- 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.
Benefits
Ensemble offers a comprehensive benefits package including healthcare, time off, retirement, and well-being programs. The company also provides reasonable accommodations for qualified individuals with disabilities and is committed to diversity, equity, and inclusion.
Pay
The Senior Patient Access Specialist at Ensemble Health Partners is paid between $18.65 - $19.90/hr based on experience.
Schedule
Hours for this role vary and may include on-call responsibilities.