Public Benefit Specialist

Ensemble Health Partners • Wyomissing, PA

7d • Onsite

About The Position

The Public Benefit Specialist interviews uninsured and under-insured patients to determine eligibility for state Medicaid benefits or a local Financial Assistance program. The role assists patients with the application process, obtains supporting documentation, and follows applications through to a determination to support timely billing or adjustment processing. The position is on-site at Tower - Reading Hospital in West Reading, Pennsylvania, and pays $18.65–$20.50 per hour, based on experience.

The specialist documents relevant actions and communications in patient accounting systems, maintains working knowledge of state and federal program requirements, and shares information with colleagues and supervisors. The role also involves maintaining proactive relationships with county, state, and federal Medicaid caseworker partners and collaborating with other revenue cycle departments and associates.

A high school diploma or GED is required; a combination of post-secondary education and experience may be considered in lieu of a degree. The position requires 1–2 years of healthcare experience interacting with patients about hospital financial issues. CRCR certification is required within nine months of hire and is company-paid. The employer offers bonus incentives, paid certifications, tuition reimbursement, comprehensive benefits, and career advancement opportunities.

Requirements

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

Nice To Haves

• Understanding of revenue cycle processes, including admission, 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 codes, or procedure codes.
• Patient Access experience with managed care or insurance and call center experience are highly preferred.
• Bilingual speaking proficiency in Spanish and English.

Responsibilities

• Review referred uninsured and under-insured patients for eligibility for benefit programs.
• Initiate and coordinate application processes to support accurate and appropriate submissions.
• Communicate with patients to obtain documents required for applications.
• Follow submitted applications through the determination point.
• Update applicable insurance information and ensure timely billing or adjustment posting.
• Document relevant actions and communication steps 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 job duties as assigned.

Benefits

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

What This Job Offers

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