Patient Access Associate Specialist

Ensemble Health Partners•Washington Court House, OH

62d•Onsite

About The Position

The Patient Access Associate Specialist plays a critical role in ensuring a seamless and positive patient experience by accurately managing patient registration and access processes within the healthcare revenue cycle. This role ensures data integrity, regulatory compliance, and a positive patient experience while directly influencing revenue cycle KPIs such as registration accuracy, point-of-service collections, and first-pass claim rates. Serves as the first point of contact for patients onsite in healthcare facilities and are essential in supporting clinical and financial operations for financial health through accurate data entry, auditing, and communication.

Requirements

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.
High School Diploma/GED
CRCR Required within 6 months of hire (Company Paid)

Responsibilities

Assigning accurate MRNs
Completing medical necessity / compliance checks
Providing proper patient instructions
Collecting insurance information
Receiving, and processing physician orders
Utilizing an overlay tool while providing excellent customer service as measured by Press Ganey
Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable
Adhering to policies and providing excellent customer service in interactions with the appropriate level of compassion
Accountable for point of service goals as assigned
Utilizing quality auditing and reporting systems to ensure accounts are corrected
Conducting audits of accounts and assuring that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access leadership
Pre-registration of patient accounts prior to patient visits
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
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, Important Message from Tricare, Observation Forms, MOON form, 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
Accurately screening 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