Senior Patient Access Specialist

Ensemble Health Partners; Mountain View Homes (SC); On-site; USD 25,000 - 28,000; Full time

Benefits offered by this job

Benefits package

Culture and values

Professional development

Job summary

Ensemble Health Partners is seeking a Senior Patient Access Specialist to perform admitting duties for all patients served, ensuring accurate MRN assignment, insurance verification, and compliant processing of orders. You will support POS collections and provide exceptional customer service across the patient access team.

The role includes on-call responsibilities, staff scheduling, and development of training materials to elevate the department’s performance and the company’s standards.

Qualifications

• 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.

Responsibilities

• Admit patients and perform front desk duties with accuracy and courtesy.
• Process insurance and demographic information and collect payments as needed.
• Explain and distribute patient education documents and consent forms.
• Assist in training and scheduling within the patient access department.
• Develop and update training materials for new hires and ongoing staff development.

Skills

Revenue cycle knowledge

Insurance verification

Medical terminology

CPT codes

AI curiosity

Education

Associate degree or Equivalent Experience

Job description

Thank you for considering a career at Ensemble! 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.

The Opportunity: CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement. This position pays between $18.65 - $19.90/hr based on experience.

The Senior Patient Access Specialist is responsible for performing admitting duties for all patients receiving services at Ensemble Health Partners. Additional duties can include training, scheduling, and other senior-level responsibilities. They are responsible for performing these functions while meeting the mission of Ensemble Health Partners and all regulatory compliance requirements. The Senior Patient Access Specialist will work within the policies and processes that are being performed across the entire organization.

Essential Job Functions

• Patient Access staff are responsible for assigning accurate MRNs, completing medical necessity or compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician order while utilizing an overlay tool and providing excellent customer service as measured by Press Ganey.
• They will serve as the SMART for the department.
• They are to adhere to Ensemble Health Partners policies and provide excellent customer service in these interactions with the appropriate level of compassion.
• Operates the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
• 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.
• A Senior Patient Access Specialist is responsible for the development of 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.
• A Senior Patient Access Specialist is responsible for the development of staff schedules within the patient access department.
• A Senior Patient Access Specialist will have on-call responsibilities for the department, including providing after-hours support and guidance.
• As part of on-call responsibilities, the Senior Patient Access Specialist may be responsible for working unscheduled times to cover staffing issues.
• Senior Patient Access Specialist are responsible for the collection of point of service payments. These activities may be conducted in emergency, outpatient, and inpatient situations including past due balances and offering payment plan options.
• The Patient Access Specialist is expected to adhere to Ensemble Health Partners policies and provide excellent customer service in these interactions.
• Conducts audits of accounts and assures that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access Leadership.
• Senior Patient Access Specialists will be held accountable for point of service goals as assigned.
• 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, Observation Forms, 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 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.
• 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.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Job Experience

1 to 3 Years

Education Level

Associate degree or Equivalent Experience

Other Preferred Knowledge, Skills, and Abilities

• 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.

Benefits

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Our Culture – Ensemble is a place where associates do their best work and be their best selves. We put people first, last and always.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to your field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Awards and Recognition

Join an award-winning company Five-time winner of “Best in KLAS” 2020-2022, 2024-2025 Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024 Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024 Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023 Energage Top Workplaces USA 2022-2024 Fortune Media Best Workplaces in Healthcare 2024 Monster Top Workplace for Remote Work 2024 Great Place to Work certified 2023-2024 Innovation Work-Life Flexibility Leadership Purpose + Values Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive.

Equal Opportunity Employment

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.

Eligibility and Work Authorization

Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered. Individuals may reapply when located within the United States.

Accommodations

Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact [e-mail].

Pay Transparency and Compensation

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.

We believe we foster an environment where talented individuals can excel and shine. Our team believes that people are the most important part of our success and that when we take care of our people, they pay it forward by providing our clients with excellent results and world-class service.