Senior Patient Access Specialist

Ensemble Health Partners•Washington Court House, OH

3d•Onsite

About The Position

The Patient Access Senior Specialist plays a critical role in ensuring a seamless and positive patient experience by accurately managing patient registration and access processes within the healthcare revenue cycle. Ensures data integrity, regulatory compliance, and a positive patient experience while directly influencing revenue cycle KPIs such as registration accuracy, point-of-service collections, and first-pass claim rates.

Requirements

1 to 3 Years of Job Experience
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.

Nice To Haves

Associate degree or Equivalent Experience

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 and 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 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. These activities may include accounts for other employees, departments, and facilities.
Developing training materials and programs for new hires to the department, as well as 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. These activities may be conducted 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 and provides statistical data to Patient Access Leadership.
Being held accountable for point of service goals as assigned.
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, 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.