Patient Access Associate Specialist - PRN

About the role

Ensemble is a leading provider of technology‑enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. The Patient Access Specialist is an entry‑level, onsite position at HSHS – St. Nicholas Hospital in Sheboygan, WI, responsible for performing admitting duties for all patients admitted for services at the hospital while meeting organizational mission, goals, and regulatory compliance requirements.

Responsibilities

• Assign accurate medical record numbers (MRNs) and complete medical necessity/compliance checks.
• Provide proper patient instructions, collect insurance information, receive and process physician orders, and utilize the overlay tool while delivering excellent customer service measured by Press Ganey.
• Operate the telephone switchboard to relay incoming, outgoing, and inter‑office calls with compassion and adherence to policies.
• Meet point‑of‑service (POS) goals as assigned.
• Utilize quality auditing and reporting systems to ensure accounts are corrected, including audits of accounts for other employees, departments, and facilities.
• Conduct audits of accounts, ensure forms are completed accurately and timely, and provide statistical data to Patient Access leadership.
• Pre‑register patient accounts prior to visits, including inbound and outbound calls to obtain demographic, insurance, and financial liability information; collect POS collections and past‑due balances, and discuss payment plan options.
• Explain general consent for treatment forms, obtain necessary signatures and witnesses, and distribute patient education documents (e.g., Medicare messages, Tricare messages, Observation Forms, MOON form, consent forms).
• Review eligibility responses in the insurance verification system, select appropriate insurance plan codes, and enter benefit data to support POS collections and billing processes.
• Screen medical necessity using Advanced Beneficiary Notice (ABN) software for Medicare patients and distribute/document ABNs as appropriate.
• Distribute and document other designated forms and pamphlets.

Experience and Qualifications

• 1+ years of customer service experience.
• Inquisitive mindset with openness to innovation, including AI, to improve patient and client experiences.

Education and Certifications

• High School Diploma or GED required.
• HFMA Certified Revenue Cycle Representative (CRCR) to be obtained within 9 months of hire.

Pay

$17.00 – $18.15 per hour, based on experience.

Schedule

PRN shifts with weekends (every 6th weekend from 3 p.m. – 11 p.m.), holidays, and on‑call.

Benefits

• Bonus incentives.
• Paid certifications.
• Tuition reimbursement.
• Comprehensive benefits package (healthcare, time off, retirement, and well‑being programs).
• Career advancement opportunities.
• Quarterly and annual incentive programs.
• Professional development support, including certification assistance.