Associate Specialist, Patient Access

Ensemble Health Partners•Urbana, OH

1d•$19 - $20•Onsite

About The Position

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

Requirements

1 to 3 Years of Job Experience
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

Responsibilities

Assign accurate MRNs, complete medical necessity or compliance checks, provide proper patient instructions, collect insurance information, receive and process physician orders while utilizing an overlay tool and providing excellent customer service.
Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
Utilize quality auditing and reporting systems to ensure accounts are corrected.
Develop 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.
Develop staff schedules within the patient access department.
Have on-call responsibilities for the department, including providing after-hours support and guidance. May be responsible for working unscheduled times to cover staffing issues.
Collect point of service payments in emergency, outpatient, and inpatient situations including past due balances and offering payment plan options.
Conduct audits of accounts and assure that all forms are completed accurately and timely to meet audit standards and provide statistical data to Patient Access Leadership.
Explain general consent for treatment forms to the patient/guarantor/legal guardian, obtain necessary signatures and witness’s name.
Explain and distribute patient education documents, such as Important Message from Medicare, Observation Forms, Consent forms, and all forms implemented for future services.
Review eligibility responses in insurance verification system and appropriately select the applicable insurance plan code, enter 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.
Accurately screen for 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.
Distribute and document other designated forms and pamphlets.