Patient Access Representative

4 weeks ago

Lewes, Delaware, United States Ensemble Health Partners Full time
Job Summary:

Ensemble Health Partners is seeking a highly skilled Patient Access Specialist to join our team. As a Patient Access Specialist, you will be responsible for performing admission 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 pre-registration of patient accounts before 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 and obtains necessary signatures and the 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 the insurance verification system and appropriately selects the applicable insurance plan code, enters benefit data into the system to support (POS) Point of Service Collections and billing processes to assist with a clean claim rate.
  • Responsible for accurately screening medical necessity using the Advance Beneficiary Notice (ABN) software to inform Medicare patients of potential non-payment of tests by Medicare and distribution of the ABN as appropriate. Responsible for distribution and documentation of other designated forms and pamphlets.
  • 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. Conducts audits of accounts and assures that all forms are completed accurately, and on time to meet audit standards and provides statistical data to Patient Access leadership.
Requirements:
  • High School Diploma/GED Required
  • CRCR Certification (Certified Revenue Cycle Representative) Required within 6 months of hire
Preferred Qualifications:
  • 1+ years of customer service experience
About Ensemble Health Partners:

Ensemble Health Partners is an award-winning company that provides revenue cycle management solutions for health systems. We are committed to empowering our people to challenge the status quo and make a meaningful difference in the lives of our patients. We offer a comprehensive benefits package, professional development opportunities, and a culture that values collaboration, growth, and innovation. If you are a motivated and customer-focused individual who is passionate about delivering exceptional patient care, we encourage you to apply for this exciting opportunity.

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