Senior Specialist, Patient Access

Ensemble Health Partners • Pittsburgh, PA

20d • $20 - $21 • Onsite

About The Position

The Senior Patient Access Specialist performs admitting and patient access duties for patients receiving hospital services while following Ensemble Health Partners’ policies, organizational goals, and regulatory requirements. The role includes collecting and verifying patient and insurance information, processing physician orders, completing compliance and medical-necessity checks, supporting accurate registration and billing, and providing compassionate customer service. The position may also include training, scheduling, auditing, point-of-service collections, telephone switchboard duties, and on-call support, including coverage for staffing needs. This is an onsite role at Mary Washington Hospital in Fredericksburg, Virginia. The listed pay range is $19.55–$20.90 per hour, based on experience.

Requirements

• 1 to 3 years of experience in a similar role.
• Ability to work onsite at Mary Washington Hospital in Fredericksburg, Virginia.
• Associate degree or equivalent experience.
• Understanding of the revenue cycle, 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, CPT, or procedure codes.

Responsibilities

• Perform admitting duties for patients receiving hospital services and follow organizational policies and regulatory requirements.
• Assign accurate medical record numbers, complete medical-necessity and compliance checks, collect insurance information, process physician orders, and provide patient instructions and customer service.
• Serve as the department SMART and operate the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
• Use quality auditing and reporting systems to identify and correct accounts, including accounts associated with other employees, departments, and facilities.
• Develop training materials and programs for new hires and provide continuing education to associates across revenue cycle areas.
• Develop staff schedules for the patient access department.
• Provide on-call support and guidance after hours, including working unscheduled times to cover staffing issues.
• Collect point-of-service payments in emergency, outpatient, and inpatient settings, including past-due balances, and offer payment plan options.
• Audit accounts, ensure forms are completed accurately and on time, provide statistical data to Patient Access Leadership, and meet assigned point-of-service goals.
• Explain general consent forms, obtain required signatures and witness names, and distribute patient education documents and required 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 Medicare medical necessity using Advanced Beneficiary Notice software, inform patients of possible non-payment, 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.
• Tuition reimbursement.
• Comprehensive benefits package, including healthcare, time off, retirement, and well-being programs.
• Career advancement and professional development opportunities.

What This Job Offers

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