Public Benefit Specialist
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.
About the role
This position is located on-site at Tower - Reading Hospital in West Reading, PA. The role involves interviewing uninsured/under-insured patients to determine eligibility for state Medicaid benefits or local Financial Assistance programs. You will assist with application processes to facilitate accurate and appropriate submissions and follow up on submitted applications to ensure timely billing or adjustment processing.
Responsibilities
- Review all referred uninsured/under-insured patients for program eligibility opportunities, initializing and coordinating the application process to facilitate accurate and appropriate submissions.
- Effectively communicate with patients to obtain documents that must accompany the application.
- Follow submitted applications to the 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 a 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 the patient insurance process for obtaining authorizations and benefits verification.
- Knowledge of Health Insurance requirements.
- Knowledge of medical terminology, 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.
- Bilingual speaking proficiency in Spanish/English.
Qualifications
- High School Diploma or GED. A combination of post-secondary education and experience will be considered in lieu of a degree.
- CRCR certification required within 9 months of hire (Company Paid).
Benefits
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
- Associate Benefits – Comprehensive benefits package designed to support physical, emotional, and financial health, including healthcare, time off, retirement, and well-being programs.
- Culture – A place where associates can do their best work and be their best selves, rooted in collaboration, growth, and innovation.
- Growth – Investment in professional development, including earning a professional certification relevant to your field.
- Recognition – Quarterly and annual incentive programs for employees who go beyond and raise the bar.
Pay
$18.65 - $20.50 per hour, based on experience.
About Ensemble
Ensemble is an award-winning company recognized for excellence in revenue cycle management:
- Five-time winner of “Best in KLAS” (2020-2022, 2024-2025)
- Black Book Research's Top Revenue Cycle Management Outsourcing Solution (2021-2024)
- 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle (2019-2024)
- Leader in Everest Group's RCM Operations PEAK Matrix Assessment (2024)
- Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance (2020, 2022-2023)
- Energage Top Workplaces USA (2022-2024)
- Fortune Media Best Workplaces in Healthcare (2024)
- Monster Top Workplace for Remote Work (2024)
- Great Place to Work certified (2023-2024)