Public Benefit Specialist

Ensemble Health Partners • Pittsburgh, PA

6d • $19 - $21 • Onsite

About The Position

Ensemble is hiring a Public Benefit Specialist to interview uninsured or under-insured patients and determine whether they may qualify for state Medicaid benefits or a hospital-system Financial Assistance program. The specialist assists patients with applications, supports accurate and appropriate submissions, and follows up until a determination is reached so billing or account adjustments can be processed in a timely manner. This is an onsite position at a hospital system in Pittsburgh, Pennsylvania, paying $18.65–$20.50 per hour based on experience.

The role involves communicating with patients to obtain required application documents, documenting actions and communications in patient accounting systems, and maintaining current knowledge of state and federal program requirements. The specialist also coordinates with county, state, and federal Medicaid caseworkers and collaborates with 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 that degree. CRCR certification is required within nine months of hire.

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 CRCR certification within nine months of hire.

Nice To Haves

• Understanding of the revenue cycle, 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, or procedure codes.
• Patient Access experience with managed care or insurance is highly preferred.
• Call Center experience is highly preferred.
• Inquisitiveness and openness to innovation, including AI, to explore better processes and improve patient and client experiences.

Responsibilities

• Review referred uninsured or under-insured patients for eligibility opportunities and initiate and coordinate applications.
• Communicate with patients to obtain documents required for applications.
• Follow submitted applications through determination, update applicable insurance information, and ensure timely billing or adjustment posting.
• Document relevant actions and communications 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 and quarterly and annual incentive programs.
• Paid professional certifications.
• Tuition reimbursement.
• Comprehensive benefits, including healthcare, time off, retirement, and well-being programs.
• Career advancement and professional development opportunities.

What This Job Offers

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