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, initializing and coordinating 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, updating applicable insurance information and ensuring 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 relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.
• Perform other job duties as assigned.

Employment Qualifications

• Minimum years and type of experience: 1–2 years of experience in healthcare industry, interacting with patients regarding hospital financial issues.
• Other knowledge, skills, and abilities preferred:
  • Understanding of Revenue Cycle including admission, billing, payments and denials.
  • Comprehensive knowledge of patient insurance process 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.
• Minimum Education: High School Diploma or GED. Combination of post-secondary education and experience will be considered in lieu of degree.
• Certifications: CRCR 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/hr. based on experience.

Schedule

This position is located on-site at Mercy – St. Vincent Medical Center in Toledo, OH.