Patient specialist

Description

This position is an onsite role, and candidates must be able to work on-site at the hospital.

The Patient Access Specialist is responsible for performing admitting duties for all patients admitted for services at the hospital.

They are responsible for performing these functions while meeting the mission and goals of the organization and all regulatory compliance requirements.

The Representative will work within the policies and processes as they are being performed across the entire organization.

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 a overlay tool while providing excellent customer service as measured by Press Ganey.

Operates the telephone switchboard to relay incoming, out-going 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. 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.

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 / legalguardian, obtains necessary signatures and witnesses 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.

Experience :

1+ years of customer service experience

Required Education :

High School Diploma / GED Required

Certification :

CRCR Required within 6 months of hire

Join an award-winning company Three-time winner of Best in KLAS 2020-20222022 Top Workplaces Healthcare Industry Award2022 Top Workplaces USA Award2022 Top Workplaces Culture Excellence Awards

Innovation

Work-Life Flexibility

Leadership

Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include :

• Our Culture Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always.

Our culture is rooted in collaboration, growth, and innovation.

• Growth We invest in your professional development. Each associate will earn a professional certification relevant to their 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.

Ensemble Health Partners 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 Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

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.

If you require accommodation in the application process, please contact .EEOC Know Your Rights

FMLA Rights - EnglishLa FMLA Español

Last updated : 2023-10-30