Senior Specialist, Patient Access

Career Opportunity

Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement

This position pays between $18.65 - $19.90/hr based on experience
This position is an onsite role, and candidates must be able to work on-site at Beebe - Main Campus in Lewes, DE

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.

Responsibilities

• Assigning accurate MRNs, completing medical necessity or compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders while utilizing an overlay tool, and providing excellent customer service as measured by Press Ganey.
• Serving as the SMART for the department, adhering to Ensemble Health Partners policies, and providing excellent customer service in these interactions with the appropriate level of compassion.
• Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
• 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 assuring that all forms are completed accurately, timely to meet audit standards, and providing statistical data to Patient Access Leadership.
• Explaining general consent for treatment forms to the patient/guarantor/legal guardian, obtaining necessary signatures and witness’s name.
• Explaining and distributing patient education documents, such as Important Message from Medicare, Observation Forms, 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 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.
• 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.
• Distribution and documentation of other designated forms and pamphlets.

Requirements

1 to 3 Years 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
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

Join An Award-winning Company
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 Monster Top Workplace for Remote Work 2024 Great Place to Work certified 2023-2024 InnovationWork-Life FlexibilityLeadershipPurpose + Values

Benefits

Award-winning company with multiple recognitions
Comprehensive benefits package including healthcare, time off, retirement, and well-being programs
Professional certification relevant to their field and tuition reimbursement
Quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company

Pay

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

Schedule

This position is an onsite role, and candidates must be able to work on-site at Beebe - Main Campus in Lewes, DE