Patient Access Representative

4 weeks ago

Warren, Michigan, United States Ensemble Health Partners Full time
Role Summary

Ensemble Health Partners is seeking a skilled Patient Access Specialist to join our team. As a Patient Access Specialist, you will be responsible for performing admitting duties for all patients admitted for services at the hospital. This includes assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders, and utilizing an overlay tool while providing excellent customer service as measured by Press Ganey.

Key Responsibilities
  • Patient Access staff are responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders, and utilizing an overlay tool while providing excellent customer service as measured by Press Ganey.
  • Operates the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
  • They are to adhere to policies and provide excellent customer service in these interactions with the appropriate level of compassion.
  • Patient Access staff will be held accountable for point of service goals as assigned.
  • Patient Access staff are responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities.
  • Patient Access Staff are responsible for the pre-registration of patient accounts prior to patient visits. This may include inbound and outbound calling to obtain demographic, insurance, and other patient information including the patient financial liabilities including collecting point of service collections as well as past due balances including payment plan options.
  • The Patient Access Staff explains general consent for treatment forms to the patient/guarantor/legal guardian, obtains necessary signatures and witness's name. Explains and distributes patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.
  • Reviews eligibility responses in insurance verification system and appropriately selects the applicable insurance plan code, enters benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.
  • Responsible for 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. Responsible for distribution and documentation of other designated forms and pamphlets.
Requirements

•1+ years of customer service experience

Education

•High School Diploma/GED Required

Certifications

•CRCR Required within 9 months of hire (Company Paid)

About Ensemble Health Partners

Ensemble Health Partners is an award-winning company that values its employees and provides a comprehensive benefits package, opportunities for growth and development, and a supportive work environment. We are committed to empowering our associates to thrive and make a meaningful impact in the healthcare industry.

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