Patient Access Specialist

Ensemble Health Partners•Roanoke, VA

1d•Onsite

About The Position

This position is an onsite role, and candidates must be able to work on-site at Carillion- Roanoke Memorial Hospital in Roanoke, VA. We are searching for the next Patient Access Specialist champion. This role is responsible for performing admitting duties for all patients admitted for services at the hospital. They are responsible for performing 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 Required within 9 months of hire (Company Paid)

Nice To Haves

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.

Responsibilities

Assign accurate MRNs, complete medical necessity / compliance checks, provide proper patient instructions, collect insurance information, receive and process physician orders, and utilize a overlay tool while providing excellent customer service as measured by Press Ganey.
Operate the telephone switchboard to relay incoming, out-going 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.
Utilize quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities.
Conduct audits of accounts and assure that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access leadership.
Pre-register patient accounts prior to 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.
Explain general consent for treatment forms to the patient/guarantor/legal guardian, obtain necessary signatures and witnesses name.
Explain and distribute 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.
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.
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.