Public Benefit Specialist

Ensemble Health Partners • Roanoke, VA

5d • 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 specialist helps patients complete applications, follows up through eligibility determinations, and ensures that resulting billing or account adjustments are processed in a timely manner. The role is based on-site at Carilion - Roanoke Memorial Hospital in Roanoke, Virginia, and pays $18.65–$20.50 per hour based on experience.

The specialist reviews referred patients for program eligibility, coordinates applications and supporting documentation, updates insurance information, and records relevant actions in patient accounting systems. The role also requires maintaining knowledge of state and federal program requirements and collaborating with patients, caseworkers, colleagues, supervisors, and other revenue cycle teams. A CRCR certification must be obtained within nine months of hire.

Requirements

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

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 codes, or procedure codes.
• Patient Access experience with managed care or insurance and call center experience are highly preferred.

Responsibilities

• Review referred uninsured and under-insured patients for eligibility opportunities in applicable 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 determination, update applicable insurance information, and ensure timely billing or adjustment posting.
• Document relevant actions and communication in assigned patient accounting systems.
• Maintain knowledge of state and federal program requirements and share information with colleagues and supervisors.
• Develop and maintain 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, including healthcare, time off, retirement, and well-being programs
• Professional development
• Quarterly and annual incentive programs

What This Job Offers

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