Public Benefit Specialist at Ensemble Health Partners interviewing patients to determine Medicaid eligibility. Assisting with applications and maintaining relationships with Medicaid caseworkers.
Responsibilities
Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or 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.
Effectively communicating with the patient to obtain documents that must accompany the application.
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.
High School Diploma or GED.
Combination of post-secondary education and experience will be considered in lieu of degree.
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