QHSE Audit Support Professional guiding Avetta clients through pre - qualification and audit processes. Providing expert explanations and coaching on QHSE Audit requirements.
About the role
- Public Benefit Specialist interacting with patients to assist with Medicaid eligibility and financial assistance applications at healthcare revenue cycle management company in O'Fallon, IL.
Responsibilities
- Interview uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or Financial Assistance program.
- Assist with application processes to facilitate accurate and appropriate submissions.
- Follow-up on submitted applications to ensure timely billing or adjustment processing.
- Review all referred uninsured/under-insured patients for program eligibility opportunities, initializing and coordinating the application process.
- Communicate effectively with the patient to obtain documents that must accompany the application.
- Document all relevant actions and communication steps in assigned patient accounting systems.
- Maintain knowledge of all state and federal program requirements; share information with colleagues and supervisors.
- Develop and maintain proactive working relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.
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.
- High School Diploma or GED.
Benefits
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
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