Senior Patient Access Specialist

Ensemble Health Partners • Greenville, SC

6d

About The Position

The Senior Patient Access Specialist performs admitting and patient access duties for patients receiving services at Ensemble Health Partners. The role supports accurate registration, insurance verification, medical necessity and compliance checks, patient instructions, physician orders, point-of-service collections, and excellent customer service while adhering to organizational policies and regulatory requirements. Additional senior-level responsibilities include serving as the department SMART, developing training materials, educating associates, creating staff schedules, conducting account audits, and providing on-call support, including after-hours guidance and coverage for staffing needs.

Requirements

• 1 to 3 years of job experience.
• Associate degree or equivalent experience.
• Understanding of revenue cycle processes, including admission, 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.
• Inquisitiveness and openness to innovation, including AI, to explore better processes and improve patient and client experiences.

Responsibilities

• Assign accurate medical record numbers (MRNs), 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 and adhere to Ensemble Health Partners policies and regulatory requirements.
• Serve as the SMART for the department.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls, as applicable.
• Use quality auditing and reporting systems to identify and ensure correction of accounts, including accounts for other employees, departments, and facilities.
• Develop training materials and programs for new hires and provide continuing education to associates in revenue cycle areas.
• Develop staff schedules for the patient access department.
• Provide on-call departmental support, including after-hours guidance and unscheduled coverage for 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 to meet audit standards, and provide statistical data to Patient Access Leadership.
• Meet assigned point-of-service goals.
• Explain general consent for treatment forms, obtain necessary signatures, and document the witness’s name.
• Explain and distribute patient education documents, including Medicare notices, observation forms, consent forms, and other designated forms.
• Review insurance eligibility responses, select applicable insurance plan codes, and enter benefit data to support point-of-service collections and billing.
• Pre-register patient accounts and make inbound and outbound calls to obtain demographic, insurance, and other patient information.
• Screen medical necessity using Advanced Beneficiary Notice (ABN) software, inform Medicare patients of possible non-payment, and distribute ABNs as appropriate.
• Distribute and document other designated forms and pamphlets.

Benefits

• Bonus incentives
• Tuition reimbursement
• Comprehensive benefits package, including healthcare, time off, retirement, and well-being programs
• Professional certification relevant to the associate’s field
• Quarterly and annual incentive programs
• Career advancement opportunities

What This Job Offers

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