Senior Specialist, Patient Access

Ensemble Health Partners • Pittsburgh, PA

18d • Onsite

About The Position

The Senior Patient Access Specialist performs admitting and patient access duties for patients receiving hospital services, following organizational policies, processes, mission, and regulatory requirements. The role supports accurate patient registration and account processing, medical necessity and compliance checks, insurance verification, patient instructions, physician-order processing, and compassionate customer service. It may also involve training, scheduling, quality auditing, and other senior-level departmental responsibilities.

The specialist develops training materials and programs for new hires and provides continuing education to associates across revenue cycle areas. The role develops staff schedules, serves as the department’s SMART, and provides on-call, after-hours support and guidance, including covering unscheduled staffing needs. Responsibilities also include collecting point-of-service payments, conducting account audits, and providing statistical data to Patient Access leadership.

This is an onsite position at Mary Washington Hospital in Fredericksburg, Virginia. The posted pay range is $19.55–$20.90 per hour, based on experience.

Requirements

• 1 to 3 years of experience in a similar role.
• Understanding of revenue cycle functions, 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 codes, or procedure codes.
• Associate degree or equivalent experience.

Responsibilities

• Perform admitting duties for patients receiving services at the hospital.
• 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 excellent, compassionate customer service and adhere to organizational policies and processes.
• 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 associated with 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 and after-hours departmental support and guidance, and cover unscheduled staffing needs when necessary.
• Collect point-of-service payments in emergency, outpatient, and inpatient settings, including past-due balances, and offer payment-plan options.
• Meet assigned point-of-service collection goals.
• Audit accounts, ensure forms are completed accurately and on time to meet audit standards, and provide statistical data to Patient Access leadership.
• Explain general consent-for-treatment forms, obtain required signatures, and record the witness’s name.
• Explain and distribute patient education documents and required forms, including Medicare notices, observation forms, and consent forms.
• Review insurance eligibility responses, select the applicable insurance plan code, and enter benefit data to support point-of-service collections and billing.
• Pre-register patient accounts and make inbound or outbound calls to obtain demographic, insurance, and other patient information.
• Screen medical necessity using Advanced Beneficiary Notice (ABN) software, inform Medicare patients of possible nonpayment, and distribute ABNs as appropriate.
• Distribute and document other designated forms and pamphlets.

Benefits

• Bonus incentives
• Paid certifications
• Tuition reimbursement
• Comprehensive benefits, including healthcare, time off, retirement, and well-being programs
• Professional development and career advancement opportunities
• Quarterly and annual incentive programs

What This Job Offers

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