Sr. Patient Access Specialist

Ensemble Health Partners•Saint Paul, MN

1d•Onsite

About The Position

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

Requirements

1 to 3 years in a similar role
Understanding of Revenue Cycle including admission, billing, payments, and denials
Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification
Knowledge of Health Insurance requirements
Knowledge of medical terminology or CPT or procedure codes
Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences

Nice To Haves

Associate degree or equivalent experience

Responsibilities

Performing admitting duties for all patients receiving services at Ensemble Health Partners.
Training, scheduling, and other senior-level responsibilities.
Performing functions while meeting the mission of Ensemble Health Partners and all regulatory compliance requirements.
Working within the policies and processes that are being performed across the entire organization.
Assigning accurate MRNs, completing medical necessity or compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders while utilizing an overlay tool and providing excellent customer service as measured by Press Ganey.
Serving as the SMART for the department.
Adhering to Ensemble Health Partners’ policies and providing excellent customer service in interactions with the appropriate level of compassion.
Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
Utilizing quality auditing and reporting systems to ensure accounts are corrected.
Developing training materials and programs for new hires to the department, as well as providing continuing education to associates in all areas of the revenue cycle.
Developing staff schedules within the patient access department.
Having on-call responsibilities for the department, including providing after-hours support and guidance.
Working unscheduled times to cover staffing issues as part of on-call responsibilities.
Collecting point of service payments in emergency, outpatient, and inpatient situations including past due balances and offering payment plan options.
Conducting audits of accounts and assuring that all forms are completed accurately and timely to meet audit standards and providing statistical data to Patient Access Leadership.
Being held accountable for point of service goals as assigned.
Explaining general consent for treatment forms to the patient/guarantor/legal guardian, obtaining necessary signatures and witness’s name.
Explaining and distributing patient education documents, such as Important Message from Medicare, Observation Forms, Consent forms, and all forms implemented for future services.
Reviewing eligibility responses in insurance verification system and appropriately selecting the applicable insurance plan code, entering benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate including pre-registration of patient accounts prior to the patient visit which may include inbound and outbound calls to obtain demographic information, insurance information, and all other patient information.
Accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate.
Distributing and documenting other designated forms and pamphlets.
Being inquisitive and demonstrating openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.