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.
The Opportunity
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
This position pays between $18.65 - $20.50 based on experience. This position is located On-Site at Firelands - South Business Office in Sandusky, OH.
Responsibilities
- Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or location Financial Assistance program.
- Assists with application processes to facilitate accurate and appropriate submissions.
- Follows-up on submitted applications to insure timely billing or adjustment processing.
- Reviews all referred uninsured/under-insured patients for program eligibility opportunities, initializing and coordinating the application process to facilitate accurate and appropriate submissions.
- Effectively communicates with the patient to obtain documents that must accompany the application.
- Follows submitted applications to determination point, updating applicable insurance information and ensuring timely billing or adjustment posting.
- Documents all relevant actions and communication steps in assigned patient accounting systems.
- Maintains working knowledge of all state and federal program requirements; shares information with colleagues and supervisors.
- Develops and maintains proactive working relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.
- Performs 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
- Associate Benefits – Comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
- Work-Life Flexibility
- Leadership
- Purpose + Values
We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.