Senior Patient Access Specialist

Ensemble Health Partners • Saint Paul, MN

1d

About The Position

The Senior Patient Access Specialist performs admitting and other patient access duties for patients receiving services at Ensemble Health Partners. The role may also include training, scheduling, auditing, and other senior-level responsibilities. The specialist is expected to follow Ensemble’s policies, meet regulatory requirements, and provide compassionate, high-quality service to patients, clients, and colleagues.

The position supports accurate patient registration and revenue-cycle operations, including medical necessity and compliance checks, collecting and verifying patient and insurance information, processing physician orders, explaining and obtaining signatures on required forms, and collecting point-of-service payments. Senior specialists also support department operations by training new hires and current associates, developing staff schedules, auditing accounts, reporting results to leadership, and providing on-call guidance and coverage when needed.

Requirements

• 1 to 3 years of experience in a similar role.
• Associate degree or equivalent experience.
• Understanding of revenue cycle processes, 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, or procedure codes.
• Inquisitiveness and openness to innovation, including AI, to explore improved processes and reduce friction in patient and client experiences.

Responsibilities

• Perform admitting and patient access duties, including assigning accurate medical record numbers (MRNs), completing medical necessity or compliance checks, collecting insurance information, processing physician orders, and giving patients appropriate instructions.
• Provide excellent, compassionate customer service in accordance with Ensemble Health Partners policies and applicable regulatory requirements.
• Serve as the department’s SMART.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls, as applicable.
• Use quality auditing and reporting systems to identify and correct account issues, including accounts associated with other employees, departments, and facilities.
• Develop training materials and programs for new department hires and provide continuing education to associates across revenue-cycle areas.
• Develop staff schedules for the patient access department.
• Provide on-call department support and guidance after hours and, when needed, work unscheduled times to address staffing coverage 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 accurately and timely completed to meet audit standards, and provide statistical data to Patient Access Leadership.
• Meet assigned point-of-service collection goals.
• Explain general consent-for-treatment forms to patients, guarantors, or legal guardians; obtain required signatures and witness names.
• Explain and distribute patient education and required documents, including Medicare Important Message, observation, and consent forms, as well as other forms implemented for future services.
• Review eligibility responses in the insurance verification system, select applicable insurance plan codes, and enter benefit data to support collections and billing.
• Support clean claims through patient account preregistration, including inbound and outbound calls to obtain demographic, insurance, and other patient information.
• Screen medical necessity using Advanced Beneficiary Notice (ABN) software, inform Medicare patients when tests may not be covered, and distribute ABNs as appropriate.
• Distribute and document other designated forms and pamphlets.
• Perform other job-related duties as required by a supervisor, subject to reasonable accommodation.

Benefits

• $1,500 sign-on bonus.
• Bonus incentives.
• Paid certifications.
• Tuition reimbursement.
• Comprehensive benefits package, including healthcare, time off, retirement, and well-being programs.
• Professional development and career advancement opportunities.
• Quarterly and annual incentive programs for employees who exceed expectations.

What This Job Offers

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