North Central Health Care · 15 hours ago
Enrollment Benefits Specialist
Wausau, WI
Full-time
Onsite
Entry Level
$19.40/hr - $21.13/hr
1+ years expNorth Central Health Care is a healthcare organization dedicated to providing high-quality care for individuals and families. The Enrollment Benefits Specialist plays a critical role in ensuring accurate enrollment, insurance verification, and benefit coordination for both inpatient and outpatient services.
Addiction TreatmentHealth CareHealth DiagnosticsMental HealthPersonal Health
Responsibilities
Complete all aspects of the enrollment process for outpatient and inpatient admissions, hospital discharges, and walk-in or scheduled intakes
Verify insurance eligibility, benefits, co-payments, deductibles, and authorization requirements using payer portals and eligibility systems
Identify services requiring prior authorization and initiate the authorization process or route information to appropriate staff
Review daily appointment schedules in advance to ensure accurate demographic, insurance, authorization, and guarantor information
Contact guardians of ant minor patient to ensure guardian attendance during appointments
Resolve insurance discrepancies to support timely and accurate billing
Meet with clients, guardians, or power of attorney representatives to obtain required signatures and documentation, including but not limited to:
Informed consent for services
Rights and notices
Releases of information
Financial responsibility documents
Medicare-related notices and forms
Verify guardianship and legal status and ensure appropriate documentation is maintained in the electronic medical record (EMR)
Ensure completeness and accuracy of registration information entered by other departments and make corrections as needed
Maintain and review Ability to Pay (ATP) information, including income documentation and financial reviews
Communicate ATP determinations to clients through in-person discussions, phone calls, and written correspondence
Collaborate with Patient Accounts regarding payment plans, financial assistance options, and account updates
Collaborate with providers, referral coordinators, and external partners to ensure enrollment requirements are met prior to scheduling services, including school-based and telehealth services
Mail any required enrollment, crisis, or discharge packets as applicable
Maintain ongoing communication with internal departments to ensure accurate client status updates
Accurately enter and update demographic, insurance, encounter, and financial information in the EMR
Utilize office systems, software, and technology to track enrollment activity, documentation, and compliance
Maintain confidentiality and compliance with HIPAA, state, and federal regulations at all times
Participate in cross-training and coverage as needed to support Patient Access operations
Perform other duties as assigned
Qualification
Required
High School Diploma or equivalent
More than 1 year of customer service experience in healthcare, insurance, or a closely related field
Working knowledge of insurance plans, eligibility verification, and billing practices
Preferred
Associate's Degree in a healthcare-related field
More than 1 year of experience with medical billing, registration, or enrollment processes
Experience working with diverse patient populations, including individuals with mental health and substance use disorders
Benefits
PTO
Paid holidays
Health insurance
Dental insurance
Vision insurance
On-site bistro and cafeteria
Pharmacy
Newly updated facility
Life insurance
Accident insurance
Hospital insurance
Employee assistance program
Wisconsin Retirement System (WRS)
Company
North Central Health Care
NCHC services focus on mental health care, addiction and substance abuse treatment.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Gary Bezucha
Chief Executive Officer
Kristen Wurth
HR Business Partner
Company data provided by crunchbase