Senior Patient Access Specialist

Ensemble Health Partners • Newport News, VA

1d

About The Position

The Senior Patient Access Specialist performs admitting and patient access duties for patients receiving services at Ensemble Health Partners, while meeting organizational, regulatory, and customer-service requirements. The position may also include training, scheduling, auditing, and other senior-level responsibilities. The specialist works within organization-wide policies and processes and serves as the department’s SMART.

Responsibilities include gathering and verifying patient and insurance information, assigning accurate medical record numbers, processing physician orders, completing medical-necessity and compliance checks, explaining and obtaining consent forms, and supporting pre-registration and clean-claim processes. The role also involves collecting point-of-service payments, conducting account audits, supporting staff through training and continuing education, developing schedules, and providing on-call guidance and coverage when needed.

Requirements

• One to three years of job experience.
• Associate degree or equivalent experience.
• Understanding of the revenue cycle, including admissions, billing, payments, and denials.
• Comprehensive knowledge of patient insurance processes for obtaining authorizations and verifying benefits.
• Knowledge of health insurance requirements.
• Knowledge of medical terminology, CPT codes, or procedure codes.
• Inquisitiveness and openness to innovation, including AI, to explore improved processes and reduce friction for patients and clients.

Responsibilities

• Perform admitting and patient access duties for patients receiving services.
• Assign accurate medical record numbers, complete medical-necessity and compliance checks, provide patient instructions, collect insurance information, and receive and process physician orders using an overlay tool.
• Provide compassionate customer service consistent with organizational policies and customer-service expectations.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls, as applicable.
• Use quality-auditing and reporting systems to identify and correct accounts, including accounts associated with other employees, departments, and facilities.
• Develop training materials and programs for new hires and provide continuing education to associates across revenue-cycle areas.
• Develop staff schedules within the patient access department.
• Provide on-call departmental support and guidance after hours, and work unscheduled times when needed to address staffing issues.
• Collect point-of-service payments in emergency, outpatient, and inpatient settings, including past-due balances, and offer payment-plan options.
• Conduct account audits, ensure forms are completed accurately and on time, and provide statistical data to Patient Access Leadership.
• Meet assigned point-of-service goals.
• Explain general consent-for-treatment forms, obtain required signatures, and record the witness’s name.
• Explain and distribute patient education documents, including Medicare notices, observation forms, consent forms, and other designated materials.
• Review insurance eligibility responses, select the applicable insurance plan code, and enter benefit data to support point-of-service collections and billing.
• Pre-register patient accounts and make inbound or outbound calls to obtain demographic, insurance, and other patient information.
• Screen medical necessity using Advanced Beneficiary Notice software, inform Medicare patients of possible non-payment for tests, and distribute ABNs as appropriate.
• Distribute and document other designated forms and pamphlets.

Benefits

• Bonus incentives and quarterly and annual incentive programs.
• Paid professional certifications relevant to the associate’s field.
• Tuition reimbursement.
• Comprehensive benefits, including healthcare, time off, retirement, and well-being programs.
• Professional development and career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree