Senior Patient Access Specialist

Ensemble Health Partners • Philadelphia, PA

4d • Onsite

About The Position

The Senior Patient Access Specialist performs admitting and patient access functions for patients receiving hospital services, in accordance with organizational policies, mission and goals, and regulatory requirements. The role supports accurate registration and revenue-cycle processes while delivering compassionate, high-quality customer service. Duties include assigning accurate medical record numbers, completing medical necessity and compliance checks, collecting insurance information, receiving and processing physician orders, providing patient instructions, and meeting assigned point-of-service goals. The specialist also operates the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.

This role uses quality auditing and reporting systems to review and correct accounts, including accounts associated with other employees, departments, and facilities. The specialist conducts account audits, ensures forms are completed accurately and on time to meet audit standards, and provides statistical information to Patient Access leadership.

The position also involves pre-registering patient accounts before visits, including inbound and outbound calls to gather demographic, insurance, and other patient information. The specialist explains patient financial liabilities, collects point-of-service payments and past-due balances, and discusses payment-plan options. They explain general consent forms, obtain required signatures and witness names, and distribute and explain applicable patient education documents and forms, including Medicare and Tricare notices, observation forms, MOON forms, and consent forms.

The specialist reviews insurance eligibility responses, selects applicable insurance plan codes, and enters benefit data to support point-of-service collections and billing. They screen medical necessity using Advanced Beneficiary Notice (ABN) software, inform Medicare patients of potential non-payment for tests, distribute ABNs as appropriate, and document distribution of other designated forms and pamphlets. The role is onsite at Tower – St. Christopher's Hospital for Children in Philadelphia, Pennsylvania.

Requirements

• 2–3 years of experience in patient access or a leadership role.
• 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 or CPT or procedure codes.
• Must be inquisitive and open to innovation, including AI, to explore improved processes and ways to reduce friction and improve patient and client experiences.
• CHAA and/or CRCR certification; the company indicates certification is company-paid.

Nice To Haves

• Associate degree preferred.
• Education in healthcare administration, business administration, or a related field preferred.

Responsibilities

• Perform admitting duties for patients receiving hospital services while following organizational policies and regulatory requirements.
• Assign accurate medical record numbers and complete medical necessity and compliance checks.
• Collect insurance information, receive and process physician orders, provide patient instructions, and use the applicable overlay tool.
• Provide excellent customer service and meet assigned point-of-service goals.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
• Use quality auditing and reporting systems to review and correct accounts, including accounts for other employees, departments, and facilities.
• Conduct account audits, ensure forms are completed accurately and on time to meet audit standards, and provide statistical data to Patient Access leadership.
• Pre-register patient accounts before visits and make inbound and outbound calls to obtain demographic, insurance, and other patient information.
• Explain patient financial liabilities; collect point-of-service payments and past-due balances; and discuss payment-plan options.
• Explain general consent forms, obtain required signatures, and record the witness's name.
• Explain and distribute applicable patient education documents and forms, including Medicare and Tricare notices, observation forms, MOON forms, and consent forms.
• Review insurance eligibility responses, select applicable insurance plan codes, and enter benefit data to support point-of-service collections and billing.
• Screen medical necessity using ABN software, inform Medicare patients of possible non-payment for tests, distribute ABNs as appropriate, and document distribution of 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 package, including healthcare, time off, retirement, and well-being programs.
• Career advancement and professional development.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed