Patient Access Associate Specialist

Ensemble Health Partners•Franklin, VA

9d•Onsite

About The Position

The Patient Access Specialist is responsible for performing admission duties for all patients admitted for services at the hospital. They are responsible for fulfilling these functions while meeting the mission and goals of the organization and all regulatory compliance requirements. The Representative will work within the policies and processes as they are being performed across the entire organization.

Requirements

High School Diploma/GED Required
CRCR Certification (Certified Revenue Cycle Representative) Required within 6 months of hire (Company Paid)
1+ years of customer service 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
Reside and be authorized to work within the United States.

Responsibilities

Assigning accurate MRNs, completing medical necessity/compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders, and utilizing an overlay tool while providing excellent customer service as measured by Press Ganey.
Operates the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
Adhere to policies and provide excellent customer service in these interactions with the appropriate level of compassion.
Be held accountable for point of service goals as assigned.
Responsible for pre-registration of patient accounts before patient visits. This may include inbound and outbound calling to obtain demographic, insurance, and other patient information including the patient financial liabilities including collecting point of service collections as well as past due balances including payment plan options.
Explains general consent for treatment forms to the patient/guarantor/legal guardian and obtains necessary signatures and the witness's name.
Explains and distributes patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.
Reviews eligibility responses in the insurance verification system and appropriately selects the applicable insurance plan code, enters benefit data into the system to support (POS) Point of Service Collections and billing processes to assist with a clean claim rate.
Responsible for accurately screening medical necessity using the Advance Beneficiary Notice (ABN) software to inform Medicare patients of potential non-payment of tests by Medicare and distribution of the ABN as appropriate.
Responsible for distribution and documentation of other designated forms and pamphlets.
Responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities.
Conducts audits of accounts and assures that all forms are completed accurately, and on time to meet audit standards and provides statistical data to Patient Access leadership.