Public Benefit Specialist

About the role

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful.

O.N.E Purpose

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
• Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

Responsibilities

• Interview uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or location Financial Assistance program.
• Assist with application processes to facilitate accurate and appropriate submissions.
• Follow up on submitted applications to ensure timely billing or adjustment processing.
• Review all referred uninsured/under-insured patients for program eligibility opportunities, initialize and coordinate the application process to facilitate accurate and appropriate submissions.
• Effectively communicate with the patient to obtain documents that must accompany the application.
• Follow submitted applications to determination point, update applicable insurance information, and ensure timely billing or adjustment posting.
• Document all relevant actions and communication steps in assigned patient accounting systems.
• Maintain working knowledge of all state and federal program requirements; share information with colleagues and supervisors.
• Develop and maintain proactive working relationships with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.
• Perform other job duties as assigned.

Requirements

• 1–2 years of experience in the healthcare industry, interacting with patients regarding hospital financial issues.
• Understanding of Revenue Cycle including admission, billing, payments, and denials.
• Comprehensive knowledge of patient insurance processes for obtaining authorizations and benefits verification.
• Knowledge of health insurance requirements.
• Knowledge of medical terminology or CPT or procedure codes.
• Patient Access experience with managed care/insurance and Call Center experience highly preferred.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.
• High School Diploma or GED. Combination of post-secondary education and experience will be considered in lieu of degree.
• CRCR certification within 9 months of hire.

Benefits

• Bonus incentives
• Paid certifications
• Tuition reimbursement
• Comprehensive benefits
• Career advancement

Pay

This position pays between $18.65 – $20.50 per hour based on experience.

This position is located on-site at Mercy – St Elizabeth Youngstown Hospital, Youngstown, OH.