Description:
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners 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.
The Opportunity:
The Opportunity:
***This position is an onsite role as needed, and candidates must be able to work on-site at the hospital in Berekely Springs, WV.***
The Patient Access Specialist is responsible for performing admitting duties for all patients admitted for services at the hospital. They are responsible for fulfilling 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.
Job 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 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 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 possible non-payment of tests by Medicare and distribution of the ABN as appropriate. Responsible for distribution and documentation of other designated forms and pamphlets. Required Qualifications
- 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.
Required Qualifications
- High School Diploma/GED Required
- CRCR Required within 6 months of hire