Patient Access Specialist - PRN

Ensemble Health Partners•Summerville, SC

5d•Onsite

About The Position

This is an entry-level, onsite role responsible for performing admitting duties for all patients admitted for services at the hospital. The specialist must meet the mission and goals of the organization and all regulatory compliance requirements, working within established policies and processes. Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, offering end-to-end solutions and point solutions. They emphasize a human touch and empower their people to challenge the status quo.

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 9 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
Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls
Adhering to policies and providing excellent customer service in interactions with compassion
Meeting point of service goals
Utilizing quality auditing and reporting systems to ensure accounts are corrected
Conducting audits of accounts and assuring that all forms are completed accurately and timely to meet audit standards
Providing statistical data to Patient Access leadership
Pre-registering patient accounts prior to patient visits, including inbound and outbound calling to obtain demographic, insurance, and other patient information
Collecting point of service collections and 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
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
Accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software
Informing Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate
Distributing and documenting other designated forms and pamphlets