Patient Access Specialist
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. The Patient Access Specialist is an entry-level career opportunity 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
- 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 an 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, adhering to policies and providing excellent customer service with appropriate compassion.
- Be held accountable for point of service goals as assigned.
- Utilize quality auditing and reporting systems to ensure accounts are corrected, which 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 provide statistical data to Patient Access leadership.
- Pre-register patient accounts prior to patient visits, which may include inbound and outbound calling to obtain demographic, insurance, and other patient information including patient financial liabilities, 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 witness names.
- 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 medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribute the ABN as appropriate.
- Distribute and document other designated forms and pamphlets.
Benefits
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family
- healthcare
- time off
- retirement
- well-being programs
- Professional development
- Quarterly and annual incentive programs
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
501-1,000 employees
