Senior Patient Access Specialist

Ensemble Health Partners•Richmond, VA

21h•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. 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! The Senior Patient Access Specialist is responsible for performing admitting duties for all patients receiving services at Ensemble Health Partners. Additional duties can include training, scheduling, and other senior-level responsibilities. They are responsible for performing these functions while meeting the mission of Ensemble Health Partners and all regulatory compliance requirements. The Senior Patient Access Specialist will work within the policies and processes that are being performed across the entire organization.

Requirements

1 to 3 Years experience in a similar role
Associate degree or Equivalent Experience

Nice To Haves

Understanding of Revenue Cycle including admission, billing, payments, and denials
Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification
Knowledge of Health Insurance requirements
Knowledge of medical terminology or CPT or procedure codes
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 or compliance checks
Providing proper patient instructions
Collecting insurance information
Receiving and processing physician order while utilizing an overlay tool
Providing excellent customer service as measured by Press Ganey
Serving as the SMART for the department
Adhering to Ensemble Health Partners policies and providing excellent customer service in these interactions with the appropriate level of compassion
Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable
Utilizing quality auditing and reporting systems to ensure accounts are corrected
Developing training materials and programs for new hires to the department
Providing continuing education to associates in all areas of the revenue cycle
Developing staff schedules within the patient access department
Having on-call responsibilities for the department, including providing after-hours support and guidance
Working unscheduled times to cover staffing issues
Collecting point of service payments in emergency, outpatient, and inpatient situations including past due balances and offering payment plan options
Conducting audits of accounts and assuring that all forms are completed accurate, timely to meet audit standards
Providing statistical data to Patient Access Leadership
Explaining general consent for treatment forms to the patient/guarantor/legal guardian, obtains necessary signatures and witness’s name
Explaining and distributing patient education documents, such as Important Message from Medicare, Observation Forms, 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 including pre-registration of patient accounts prior to the patient visit which may include inbound and outbound calls to obtain demographic information, insurance information, and all other patient information
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
Distributing and documenting other designated forms and pamphlets
Being held accountable for point of service goals as assigned