Senior Patient Access Specialist

Ensemble Health Partners•Marion, VA

6d•Onsite

About The Position

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 of Job 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.
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

Responsibilities

Assigning accurate MRNs
Completing medical necessity or compliance checks
Providing proper patient instructions
Collecting insurance information
Receiving and processing physician orders while utilizing an overlay tool
Providing excellent customer service
Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls
Utilizing quality auditing and reporting systems to ensure accounts are corrected
Developing training materials and programs for new hires
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 as part of on-call responsibilities
Collecting point of service payments
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
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 to assist with a clean claim rate
Pre-registering 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
Distribution and documentation of other designated forms and pamphlets
Performing other job-related duties as required by their supervisor, subject to reasonable accommodation.