Public Benefit Specialist

Ensemble Health Partners•Lewiston, ME

12d•Onsite

About The Position

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. This position is On-Site at Covenant - St. Mary's in Lewiston, ME. The role involves interviewing uninsured/under-insured patients to determine eligibility for state Medicaid benefits or location Financial Assistance programs, assisting with application processes for accurate and appropriate submissions, and following up on submitted applications to ensure timely billing or adjustment processing.

Requirements

1-2 years of experience in healthcare industry, interacting with patients regarding hospital financial issues.
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.
CRCR within 9 months of hire. (Company Paid)

Nice To Haves

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.

Responsibilities

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.