Senior Specialist, Patient Access
Ensemble Health Partners · Pittsburgh, PA · 1 wk ago
Healthcare$18.65–$19.9/hrFull-time
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. The position pays between $18.65 - $19.90/hr based on experience and is an onsite role in Pittsburgh, PA.
Responsibilities
- Assigning accurate MRNs, completing medical necessity or compliance checks, providing patient instructions, collecting insurance information, receiving, and processing physician orders, and utilizing an overlay tool.
- Providing excellent customer service as measured by Press Ganey.
- Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls.
- Utilizing quality auditing and reporting systems to ensure accounts are corrected.
- Developing 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.
- Developing staff schedules within the patient access department.
- Having on-call responsibilities for the department, including providing after-hours support and guidance.
- Collecting point of service payments, including past due balances and offering payment plan options.
- Conducting audits of accounts and ensuring all forms are completed accurately, timely to meet audit standards.
- Explaining general consent for treatment forms to the patient/guarantor/legal guardian, obtaining necessary signatures, and distributing patient education documents.
- 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.
- Screening 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
- 1 to 3 years of relevant experience.
- 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
- 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.
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.
Benefits
Join an award-winning company with multiple recognitions including:
- Five-time winner of “Best in KLAS” 2020-2022, 2024-2025
- Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
- 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
- Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
- Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
- Energage Top Workplaces USA 2022-2024
- Fortune Media Best Workplaces in Healthcare 2024
- Monerst Top Workplace for Remote Work 2024
- Great Place to Work certified 2023-2024
Pay
This position pays between $18.65 - $19.90/hr based on experience.
Schedule
The position is an onsite role in Pittsburgh, PA.