Patient Access Specialist - PRN

Ensemble Health Partners•Pearisburg, VA

1d•Onsite

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. The Patient Access Specialist role is responsible for performing admitting duties for all patients admitted for services at the hospital, 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

Assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving and processing physician orders, and utilizing an overlay tool while providing excellent customer service as measured by Press Ganey.
Operating the telephone switchboard to relay incoming, out-going and inter-office calls as applicable, adhering to policies, and providing excellent customer service in these interactions with the appropriate level of compassion.
Being held accountable for point of service goals as assigned.
Utilizing quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities.
Conducting audits of accounts and assuring that all forms are completed accurate, timely to meet audit standards and providing statistical data to Patient Access leadership.
Pre-registration of 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.
Explaining general consent for treatment forms to the patient/guarantor/legal guardian, obtaining necessary signatures and witnesses 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 of 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.