Patient Access Associate Specialist - Part-time

Ensemble Health Partners•Sheboygan, WI

1d•Onsite

About The Position

This is an entry-level, part-time, onsite role at HSHS - St. Nicholas Hospital in Sheboygan, WI. The Patient Access Specialist champion is responsible for performing admitting duties for all patients admitted for services at the hospital, ensuring adherence to the organization's mission, goals, and regulatory compliance requirements. The Representative will work within the established policies and processes of the organization, providing excellent customer service and accurate patient information.

Requirements

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.
High School Diploma/GED
CRCR certification required within 6 months of hire (Company Paid)

Responsibilities

Performing admitting duties for all patients admitted for services at the hospital.
Meeting the mission and goals of the organization and all regulatory compliance requirements.
Working within the policies and processes as they are being performed across the entire organization.
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.
Operating the telephone switchboard to relay incoming, out-going and inter-office calls as applicable.
Adhering to policies and providing excellent customer service with the appropriate level of compassion.
Meeting point of service goals as assigned.
Utilizing quality auditing and reporting systems to ensure accounts are corrected, including accounts for other employees, departments, and facilities.
Conducting audits of accounts and assuring that all forms are completed accurately and timely to meet audit standards, and providing statistical data to Patient Access leadership.
Pre-registering patient accounts prior to patient visits, which may include inbound and outbound calling to obtain demographic, insurance, and other patient information, including patient financial liabilities, collecting point of service collections, past due balances, and payment plan options.
Explaining general consent for treatment forms to the patient/guarantor/legal guardian, obtaining necessary signatures and witnesses.
Explaining and distributing 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.
Reviewing eligibility responses in the insurance verification system and appropriately selecting the applicable insurance plan code, entering benefit data into the system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.
Accurately screening medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of tests by Medicare and distributing the ABN as appropriate.
Distributing and documenting other designated forms and pamphlets.