Public Benefit Specialist assisting uninsured/under-insured patients with Medicaid eligibility and application processes. Working at Ensemble, a provider of revenue cycle management solutions.
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 ensure 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.
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
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