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Lead Patient Access Coordinator
2 months ago
Ensemble Health Partners stands as a premier provider of technology-driven revenue cycle management solutions tailored for healthcare systems, encompassing hospitals and associated physician groups. They deliver comprehensive revenue cycle solutions alongside a robust array of point solutions to clients nationwide.
Ensemble is dedicated to maintaining community health by ensuring the vitality of hospitals. We understand that healthcare necessitates a personal touch, and we believe that every interaction should be significant. This conviction underscores that our personnel are the cornerstone of our identity. By empowering them to question conventional practices, we trust they will be the catalyst for change.
The Opportunity:
The Senior Patient Access Specialist is tasked with executing admission responsibilities for all patients receiving services at the healthcare facility. This role entails fulfilling these duties while aligning with the organization's mission and objectives, as well as adhering to all regulatory compliance standards. The Representative will operate within established policies and procedures across the organization.
Patient Access personnel are charged with assigning precise Medical Record Numbers (MRNs), conducting medical necessity and compliance evaluations, providing appropriate patient guidance, gathering insurance details, processing physician orders, and utilizing an overlay tool while delivering exceptional customer service as evaluated by Press Ganey. They will manage the telephone switchboard to facilitate incoming, outgoing, and inter-office communications as required. Adherence to policies and delivering outstanding customer service during these interactions with the necessary level of empathy is essential. Patient Access staff will be accountable for achieving assigned point-of-service objectives.
Senior Patient Access Specialists are responsible for leveraging quality auditing and reporting systems to ensure account accuracy. These tasks may involve accounts for other staff members, departments, and facilities. They will conduct audits of accounts, ensuring all documentation is completed accurately and promptly to meet audit standards, while providing statistical insights to Patient Access leadership.
Senior Patient Access Specialists are also responsible for the pre-registration of patient accounts prior to their visits. This may involve both inbound and outbound communications to collect demographic, insurance, and other pertinent patient information, including financial responsibilities and collecting point-of-service payments as well as overdue balances and payment plan options.
The Senior Patient Access Specialist will clarify general consent for treatment forms to the patient, guarantor, or legal guardian, securing necessary signatures and witness information. They will explain and distribute patient education materials, such as Important Messages from Medicare, Important Messages from Tricare, Observation Forms, MOON forms, Consent forms, and any forms required for future services.
They will review eligibility responses within the insurance verification system, accurately selecting the appropriate insurance plan code and entering benefit data into the system to support point-of-service collections and billing processes, thereby aiding in achieving a clean claim rate.
Additionally, they will be responsible for the accurate screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of potential non-payment for tests by Medicare and will distribute the ABN as necessary. They will also manage the distribution and documentation of other designated forms and informational pamphlets.
Employment Qualifications:
Certified Healthcare Access Associate (CHAA) and/or Certified Revenue Cycle Representative (CRCR). (Company Paid)
Other Preferred Knowledge, Skills, and Abilities:
2-Year/Associates Degree
Preferred Minimum Education - Specialty/Major: Healthcare administration, business administration, or a related field.
Minimum Years and Type of Experience: 2-3 years of experience in patient access or a leadership capacity.
Other Knowledge, Skills, and Abilities Required:
Comprehensive understanding of the Revenue Cycle, including admissions, billing, payments, and denials. Extensive knowledge of the patient insurance process for obtaining authorizations and benefits verification. Familiarity with Health Insurance requirements. Knowledge of medical terminology or CPT or procedure codes.
Join an award-winning company
Three-time recipient of "Best in KLAS"
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards
- Innovation
- Work-Life Flexibility
- Leadership
- Purpose + Values
- Associate Benefits - We provide a comprehensive benefits package designed to support the physical, emotional, and financial well-being of you and your family, including healthcare, time off, retirement, and wellness programs.
- Our Culture - Ensemble is a workplace where associates can excel and be their best selves. We prioritize people above all else. Our culture is founded on collaboration, growth, and innovation.
- Growth - We invest in your professional development. Each associate will earn a professional certification relevant to their field and can access tuition reimbursement.
- Recognition - We offer quarterly and annual incentive programs for all employees who exceed expectations and continuously strive for excellence.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.
