Operations Analyst in Payment Investigations at TD Securities. Collaborating with clients and internal teams for effective payment solutions and fraud recovery processes.
About the role
- Public Benefit Specialist at Ensemble assisting uninsured patients with Medicaid benefit applications and financial assistance. Involves patient interactions and collaboration with state agencies for eligibility determinations.
Responsibilities
- Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or location Financial Assistance program.
- Assists with application processes to facilitate accurate and appropriate submissions.
- Follows-up on submitted applications to insure timely billing or adjustment processing.
- Reviewing all referred uninsured/under-insured patients for program eligibility opportunities, initializing and coordinating the application process to facilitate accurate and appropriate submissions.
- Effectively communicating with the patient to obtain documents that must accompany the application.
- Following submitted applications to determination point, updating applicable insurance information and ensuring timely billing or adjustment posting.
- Documenting all relevant actions and communication steps in assigned patient accounting systems.
- Maintaining working knowledge of all state and federal program requirements; shares information with colleagues and supervisors.
- Developing and maintaining proactive working relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.
- Other job duties as assigned.
Requirements
- 1-2 years of experience in healthcare industry, interacting with patients regarding hospital financial issues.
- Understanding of Revenue Cycle including admission, billing, payments and denials.
- Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification.
- Knowledge of Health Insurance requirements.
- Knowledge of medical terminology or CPT or procedure codes.
- Patient Access experience with managed care/insurance and Call Center experience highly preferred.
- 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: High School Diploma or GED.
- Combination of post-secondary education and experience will be considered in lieu of degree.
- Certifications: CRCR within 9 months of hire.
Benefits
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
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