Patient Access Specialist

Ensemble Health Partners•Pottstown, PA

13d•Onsite

About The Position

This position is an entry-level career opportunity at Ensemble, a leading provider of technology-enabled revenue cycle management solutions for health systems. The Patient Access Specialist is responsible for performing admitting duties for all patients admitted for services at the hospital, ensuring adherence to the organization's mission, goals, and regulatory compliance requirements. The role operates within established policies and processes across the organization, focusing on providing excellent customer service and accurate account management.

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 calls
Adhering to policies and providing excellent customer service with compassion
Meeting point of service goals
Utilizing quality auditing and reporting systems to ensure accounts are corrected
Conducting audits of accounts to ensure accurate and timely completion of forms to meet audit standards
Providing statistical data to Patient Access leadership
Pre-registering 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 and collecting point of service collections as well as past due balances and 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
Distributing and documenting other designated forms and pamphlets