Health Specialist Jobs

About The Position

Requirements

• High school diploma or GED.
• Obtain the CRCR certification within nine months of hire; the company pays for the certification.
• Be inquisitive and open to innovation, including the use of AI to explore improved processes and reduce friction for patients and clients.

Nice To Haves

• One to three years of customer service experience.
• Basic understanding of Medicare and Medicaid benefits.
• Basic understanding of Labor & Delivery benefits.
• Basic understanding of how to understand and explain EOBs.
• Basic understanding of grants and research.
• Basic understanding of Black Lung qualification.
• Basic understanding of COBRA benefits.
• Basic understanding of Healthcare Sharing Ministry coverages.
• Basic understanding of billing and back-end processes.
• Basic understanding of the Defense Enrollment Eligibility Reporting Systems (DEERS) process.

Responsibilities

• Obtain patient insurance and financial information, determine estimates, and collect estimated patient liabilities—including copays, deductibles, coinsurance, and past-due or outstanding balances after financial assistance—while meeting assigned daily point-of-service collection goals.
• Notify recently discharged bedded patients who did not pay estimated liabilities, making attempts within seven days of discharge and documenting attempts in account notations.
• Participate in client-assigned daily cashiering responsibilities, including cash reconciliation and deposit functions.
• Handle flat-rate contracts, bundled services, and applicable self-pay options.
• Communicate with internal and external stakeholders about case status and escalations.
• Collaborate with Case Management and/or Utilization Management on regulatory forms, including Hospital Inpatient Notices of Non-Coverage and Lifetime Reserve Day declinations.
• Run, monitor, and work the missed collection opportunities report to identify process improvements and follow-up needs; make at least three documented attempts each day to visit or contact patients listed as inpatient.
• Maintain client- and/or Ensemble-specific work queues applicable to the FC role, including unbilled edits.
• Complete assigned follow-up reports, including reports for accounts requiring next-day verification and denial root-cause analysis.
• Manage communications with patients who are unable to make payments while in-house.
• Ensure required registration-related consents and forms are completed at or after admission.
• Develop and submit CFO escalations for uncollected estimated liabilities in accordance with financial clearance policies.
• Assist eligibility specialists with insurance verification, including Medicaid and charity processing, searches for secondary coverage, coverage queries for self-pay patients, and coordination-of-benefits education.
• Work daily queues to complete, update, and clear assigned unbilled accounts.

Benefits

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