Associate Specialist, Patient Access (PRN)
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
This position pays between $17- $18.15/hr based on experience. This position is an onsite role, and candidates must be able to work on-site at HSHS - St. Clare Hospital in Oconto Falls, WI.
Available Shifts: PRN Flexible Shifts
The Opportunity: Patient Access Specialist
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 utilization of quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities.
Credits 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/legal guardian, obtains necessary signatures and 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 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 We Love
1+ years of customer service experience.
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.
Minimum Education
A High School Diploma/GED is required.
Required Certifications
Join An Award-winning Company
CRCR Required within 9 months of hire (Company Paid)
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
Skills
Highly organized and detail-oriented.
Excellent communication and interpersonal skills.
Ability to multitask and prioritize effectively.
Proficient in Microsoft Office Suite.
Knowledge of medical terminology and coding systems.
Strong problem-solving and analytical skills.
Benefits
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 is rooted in collaboration, growth, and innovation.
We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Equal Employment Opportunity
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.