Public Benefit Specialist interviewing patients for state Medicaid eligibility and assisting with application processes while ensuring timely billing. Work located at Tower - Pottstown Hospital, Pottstown, PA.
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 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.
High School Diploma or GED.
Combination of post-secondary education and experience will be considered in lieu of degree.
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