Senior Specialist, Patient Access

About the role

The Senior Patient Access Specialist at Ensemble Health Partners is responsible for performing admitting duties for all patients receiving services, including training, scheduling, and other senior-level responsibilities. This role adheres to Ensemble Health Partners' policies and provides excellent customer service.

Responsibilities

• 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 orders while utilizing an overlay tool.
• Utilize quality auditing and reporting systems to ensure accounts are corrected, including accounts for other employees, departments, and facilities.
• Develop training materials and programs for new hires to the department, as well as provide continuing education to associates in all areas of the revenue cycle.
• Develop staff schedules within the patient access department.
• Provide on-call support for the department, including working unscheduled times to cover staffing issues.
• Collect point of service payments, including past due balances and offering payment plan options.
• Conduct audits of accounts and provide statistical data to Patient Access Leadership.
• Explain general consent for treatment forms to the patient/guarantor/legal guardian, obtain necessary signatures, and distribute patient education documents.
• Review eligibility responses in insurance verification system and appropriately select the applicable insurance plan code, enter benefit data into system, and support POS (Point of Service Collections) and billing processes.
• Screen medical necessity using the Advanced Beneficiary Notice (ABN) software and distribute and document other designated forms and pamphlets.

Requirements

Must have 1 to 3 years of experience in a similar role. 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

• Associate degree or equivalent experience.
• 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

This position offers bonus incentives, paid certifications, tuition reimbursement, comprehensive benefits, and career advancement. The Senior Patient Access Specialist is paid between $18.65 - $19.90 based on experience.

Pay

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

Schedule

Not specified.