Public Benefit Specialist

Ensemble Health Partners • Los Lunas, NM

17d • Onsite

About The Position

The Public Benefit Specialist interviews uninsured and under-insured patients to determine eligibility for state Medicaid benefits or local Financial Assistance programs. The role assists patients with application processes, follows submitted applications through determination, and helps ensure timely billing or adjustment processing. It is located on-site at Ardent - Valencia County Hospital in Los Lunas, New Mexico. The position pays $18.65–$20.50 per hour, based on experience.

The specialist documents actions and communications in patient accounting systems, maintains knowledge of state and federal program requirements, and works proactively with county, state, and federal Medicaid caseworkers as well as revenue cycle colleagues. Ensemble describes its purpose as providing exceptional experiences, embracing new ideas and technology, and striving for excellence. The company offers career advancement, bonus incentives, paid certifications, tuition reimbursement, and comprehensive benefits.

Requirements

• 1–2 years of experience in the healthcare industry interacting with patients about hospital financial issues.
• High school diploma or GED; a combination of post-secondary education and experience may be considered in lieu of a degree.
• Obtain the CRCR certification within 9 months of hire.
• Inquisitiveness and openness to innovation, including AI, to explore better processes and improve patient and client experiences.

Nice To Haves

• Understanding of revenue cycle processes, including admissions, billing, payments, and denials.
• Comprehensive knowledge of patient insurance processes for obtaining authorizations and verifying benefits.
• Knowledge of health insurance requirements.
• Knowledge of medical terminology, CPT, or procedure codes.
• Patient Access experience with managed care or insurance.
• Call Center experience.

Responsibilities

• Review referrals for uninsured and under-insured patients to identify program eligibility opportunities and coordinate application submissions.
• Communicate with patients to obtain documents required for applications.
• Follow submitted applications through the determination point, update applicable insurance information, and help ensure timely billing or adjustment posting.
• Document relevant actions and communication in assigned patient accounting systems.
• Maintain working knowledge of state and federal program requirements and share information with colleagues and supervisors.
• Develop and maintain proactive working relationships with county, state, and federal Medicaid caseworker partners.
• Collaborate with other revenue cycle departments and associates.
• Perform other duties as assigned.

Benefits

• Bonus incentives
• Paid certifications
• Tuition reimbursement
• Comprehensive benefits package, including healthcare, time off, retirement, and well-being programs
• Professional development
• Career advancement
• Quarterly and annual incentive programs

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED