Ensemble Health Partners

Health Information Specialist

• Complete analysis and reanalysis of medical records accurately and timely
• Complete accounts from EMR Waiting for Documentation and Missing Document work queues when documentation is received
• Follow up with ancillary and nursing departments for missing documentation
• Follow up with providers regarding missing documentation or dictation preventing coding
• Maintain the unbilled spreadsheet with missing-documentation status updates and send it to management
• Review electronic medical records and create and assign charting deficiencies to appropriate providers
• Manage analysis-specific electronic and manual work queues to ensure timely analysis and chart completion
• Add and reassign accounts to appropriate work queues according to company standards and workflow guidelines
• Identify systematic problems and route them to the Manager for facility resolution
• Report issues and trends that do not comply with facility or corporate policies and standards
• Document workflows, including process alterations, modifications, and changes
• Perform other duties as assigned

Health Information Management Specialist

Patient Access

• Manage patient registration and access processes
• Assign accurate MRNs and complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders and use overlay tools
• Operate the telephone switchboard
• Provide compassionate customer service to patients, clients, and colleagues
• Meet assigned point-of-service goals
• Conduct account audits and use quality auditing and reporting systems
• Complete pre-registration and inbound/outbound calls to obtain patient information
• Collect point-of-service payments and past-due balances, including payment plan options
• Explain and obtain signatures for consent and patient education forms
• Review insurance eligibility responses and enter benefit data to support collections and billing
• Screen medical necessity using ABN software and distribute required forms

Patient Access Associate

Patient Access Specialist

• Perform admitting duties for all patients receiving services
• Assign accurate MRNs and complete medical necessity or compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders using an overlay tool
• Provide customer service and serve as the department SMART
• Operate the telephone switchboard
• Use quality auditing and reporting systems to correct accounts
• Develop training materials and programs for new hires
• Provide continuing education to associates across the revenue cycle
• Develop staff schedules within the patient access department
• Provide after-hours support and guidance through on-call responsibilities
• Collect point-of-service payments and offer payment plan options
• Conduct account audits and provide statistical data to Patient Access Leadership
• Explain consent and patient education forms and obtain required signatures
• Review insurance eligibility, select insurance plan codes, and enter benefit data
• Pre-register patient accounts and make inbound and outbound calls to obtain patient information
• Screen medical necessity using ABN software and distribute and document designated forms

Senior Patient Access Specialist

Physician

• Render compliant status determinations for hospitalized patients
• Conduct peer-to-peer reviews with payors’ medical directors
• Review short inpatient stays and observation patients daily
• Build relationships with medical staff and leadership to gain support for utilization management initiatives
• Attend utilization management committees as a subject matter expert
• Assist with denials and appeals
• Educate medical staff on utilization management topics
• Partner with utilization review nurses, insurance authorization staff, and Case Management to maintain and improve utilization management processes
• Track denial trends to help the team adapt to evolving payor challenges
• Make day-to-day leadership decisions and communicate decisions to appropriate teams
• Coach, develop, delegate to, and lead teams
• Manage programs and projects from inception through completion or implementation, including budget and resource planning

Physician Advisor

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate medical record numbers (MRNs)
• Complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Operate the telephone switchboard
• Provide compassionate customer service
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Make inbound and outbound calls to obtain demographic, insurance, and patient financial information
• Collect point-of-service payments and past-due balances, including payment plan options
• Explain consent and patient education forms, obtain signatures, and document witnesses
• Review insurance eligibility responses and select applicable plan codes
• Enter benefit data to support point-of-service collections and billing processes
• Screen medical necessity using ABN software and distribute and document required forms

• Perform admitting duties for patients admitted for hospital services
• Assign accurate MRNs
• Complete medical necessity and compliance checks
• Provide patient instructions and excellent customer service
• Collect insurance information
• Receive and process physician orders
• Utilize an overlay tool
• Operate the telephone switchboard
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Make inbound and outbound calls to obtain demographic, insurance, and patient financial information
• Collect point-of-service collections and past-due balances, including payment plan options
• Explain consent forms and obtain necessary signatures and witness names
• Explain and distribute patient education documents and required forms
• Review insurance eligibility responses and select applicable insurance plan codes
• Enter benefit data to support point-of-service collections and billing processes
• Screen medical necessity using Advanced Beneficiary Notice software
• Distribute and document ABNs and other designated forms and pamphlets
• Follow organizational policies, processes, mission, regulatory compliance requirements, and customer service standards

Patient Access Associate Specialist

General

• Assist with producing, validating, and updating Ensemble Revenue Recovery technology
• Provide education to Revenue Recovery client teams regarding updates in Ensemble IQ (EIQ)
• Create Educational Spotlights in PowerPoint and Word, plus recorded training versions, on identifying and collecting underpaid claims
• Serve as a technology subject matter expert within the Revenue Recovery service line
• Validate reporting data and disseminate relevant information across the team
• Maintain the Microsoft Teams site environment containing technology documents
• Build new client rules and update existing rules
• Track hit-rate opportunities
• Research, build, upload, and test prediction rules within EIQ for new and existing clients
• Identify new underpayment opportunities
• Educate teams on updates and how and when to use prediction rules
• Regularly review prediction rules and incorporate new or updated rules into client packages
• Analyze variances and trends to identify problems
• Evaluate processes and tools and propose efficiency improvements
• Establish effective monitoring and reporting controls
• Coordinate operational objectives by contributing information and recommendations to strategic plans and reviews
• Prepare and complete action plans
• Ensure projects are completed on time and within scope
• Communicate barriers to appropriate parties
• Travel to and work onsite at client, temporary, or corporate office locations as business needs require

Revenue Recovery Technology Specialist

Financial Planning and Analysis

• Create the annual budget and quarterly forecasts
• Collaborate with business leaders on revenue and expense estimates
• Create pro forma financial models forecasting business performance and financial results
• Handle non-routine situations independently
• Analyze strategic problems, data, and information to provide financial insights and recommendations
• Use Workday Adaptive Planning to manage financial information and build workforce, revenue, and expense planning models
• Track and review actuals versus budget and forecast estimates
• Prepare variance explanations and narrate key performance drivers
• Advise on pricing and decision-making for new initiatives, clients, and business opportunities
• Prepare executive and Board presentations and investor materials
• Assist with capital planning, scenario planning, and M&A
• Document work processes, data sources, and definitions
• Define and monitor KPIs with Strategy and Analytics teams
• Partner with Accounting on month-end close items and audit support
• Determine financial impacts of strategic initiatives and incorporate them into forecasts and plans
• Partner with Operations leaders and Strategy, Accounting, and Analytics teams
• Report to the AVP of FP&A
• Travel quarterly and work onsite as business needs require

Analyst, Financial Planning & Analysis

• Complete analysis/reanalysis of all records accurately and timely
• Complete accounts from EMR Waiting for Documentation and Missing Document work queues when missing documentation is received
• Follow up with ancillary/nursing departments for missing documentation
• Follow up with providers regarding missing documentation/dictation preventing accounts from being coded
• Complete the unbilled spreadsheet with updates regarding missing documentation and send it to management
• Review medical record documentation in electronic medical records
• Create charting deficiencies in the deficiency management system and assign them to appropriate providers
• Manage analysis-specific electronic and manual work queues to ensure timely analysis and chart completion
• Adhere to company standards, policies, and system workflow guidelines
• Identify systematic problems and route them to the Manager for facility resolution
• Report issues and trends that do not comply with facility or corporate policies/standards
• Document workflows, including alterations, modifications, and process changes
• Perform other duties as assigned

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate MRNs and complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Operate the telephone switchboard and relay calls
• Perform quality audits and use reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Obtain demographic, insurance, and financial liability information through inbound and outbound calls
• Collect point-of-service payments and past-due balances, including payment plan options
• Explain consent and patient education forms, obtain signatures, and witness signatures
• Review insurance eligibility responses and enter benefit data to support collections and clean claims
• Screen Medicare medical necessity using ABN software and distribute required forms

• Complete analysis and reanalysis of all records accurately and timely
• Complete EMR Waiting for Documentation and Missing Document work queues when documentation is received
• Follow up with ancillary and nursing departments for missing documentation
• Follow up with providers regarding missing documentation or dictation preventing coding
• Update and send the unbilled spreadsheet to management
• Review electronic medical records and create and assign charting deficiencies in the deficiency management system
• Manage analysis-specific electronic and manual work queues to ensure timely analysis and chart completion
• Add and reassign accounts to appropriate work queues according to company standards and workflow guidelines
• Identify systematic problems and route them to the Manager for facility resolution
• Report issues and trends that do not comply with facility or corporate policies and standards
• Document workflows, alterations, modifications, and process changes
• Perform other duties as assigned

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate medical record numbers (MRNs)
• Complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Utilize overlay tools and provide customer service measured by Press Ganey
• Operate the telephone switchboard and relay incoming, outgoing, and inter-office calls
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and ensure forms are completed accurately and timely
• Provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Make inbound and outbound calls to obtain demographic, insurance, and patient financial liability information
• Collect point-of-service payments and past-due balances, including payment plan options
• Explain general consent forms, obtain signatures, and record witnesses' names
• Explain and distribute patient education and regulatory documents and forms
• Review insurance eligibility responses and select applicable insurance plan codes
• Enter benefit data to support point-of-service collections and billing processes
• Screen medical necessity using ABN software and distribute and document ABNs and other designated forms

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate MRNs and complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders and utilize an overlay tool
• Operate the telephone switchboard for incoming, outgoing, and inter-office calls
• Meet point-of-service goals and provide compassionate customer service
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Obtain demographic, insurance, and financial liability information through inbound and outbound calls
• Collect point-of-service payments and past-due balances, including payment plan options
• Explain consent and patient education forms, obtain signatures, and witness names
• Review insurance eligibility, select insurance plan codes, and enter benefit data to support collections and billing
• Screen Medicare medical necessity using ABN software and distribute required forms

• Render compliant status determinations for hospitalized patients
• Conduct peer-to-peer reviews with payors' medical directors
• Serve as a subject matter expert on utilization management issues
• Review short inpatient stays and observation patients daily
• Build relationships with medical staff and leadership to support utilization management initiatives
• Attend utilization management committees
• Assist with denials and appeals
• Educate medical staff on utilization management topics
• Partner with utilization review nurses, insurance authorization staff, and Case Management to strengthen utilization management processes
• Track denial trends and help the team adapt to evolving payor challenges

• Interview uninsured and under-insured patients to determine eligibility for state Medicaid benefits or local financial assistance programs
• Assist with application processes to facilitate accurate and appropriate submissions
• Follow up on submitted applications through determination
• Review referred patients for program eligibility opportunities and coordinate application processes
• Communicate with patients to obtain required supporting documents
• Update applicable insurance information and ensure timely billing or adjustment posting
• Document relevant actions and communications in patient accounting systems
• Maintain knowledge of state and federal program requirements and share information with colleagues and supervisors
• Develop and maintain working relationships with county, state, and federal Medicaid caseworker partners
• Collaborate with revenue cycle departments and associates
• Perform other assigned duties

Health Information Management Specialist

Patient Access Associate

Senior Patient Access Specialist

Physician Advisor

Patient Access Specialist

Patient Access Associate Specialist

Revenue Recovery Technology Specialist

Analyst, Financial Planning & Analysis

Health Information Management Specialist

Patient Access Associate Specialist

Health Information Management Specialist

Patient Access Associate Specialist

Patient Access Specialist

Physician Advisor

Public Benefit Specialist