Public Benefit Specialist
Company
Ensemble Health Partners
Location
Other US Location
Type
Full Time
Job Description
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners 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. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference
The Opportunity:
The Public Benefits Specialist interviews uninsured/underinsured patients to determine eligibility for a state Medicaid benefit or a health system's financial assistance program. Assists with application process to facilitate accurate and appropriate submissions. Follows-up on submitted applications to insure timely billing or adjustment processing. Maintains thorough working knowledge of department policies and procedures to act as subject matter expert for business process questions. Senior Specialist also focuses on QA completion along with peer education and training, is the 1st point of contact for questions and education opportunities, supports in leading meetings and DIBS calls, acts as a project lead to drive team collaboration, as well as providing additional support to both the leader and the team as needed.
Essential Job Functions:
- Reviews and interviews all referred uninsured/underinsured patients for potential program eligibility opportunities for state, federal, and grant funding available programs
- Has a thorough working knowledge of the rules and regulations for Medicaid, Social Security disability, Cobra and local grant programs. Acts as an authorized representative through determining appropriate eligibility, application process and submission of all documentation, and the appeal process.
- Follows submitted applications to determination point, updates applicable insurance information and ensures timely billing or adjustment posting
- Documents all relevant actions and communication steps in assigned patient accounting systems while working across multiple client systems and assigned workflows
- Works collaboratively with other revenue cycle departments and associates with a special emphasis on Case Management and Patient Access, Financial Counseling, and Physician office staff as well as county, states, and Federal Medicaid and disability partners
- Makes appropriate referrals to various community and/or Government agencies and must become certified application counselor and assist in the Affordable Care Act Marketplace enrollment process to guide patients on the application process and selection of plans
- Participate in client’s documentation retrieval for audits as well as understanding of client payors, eligibility portals, basic knowledge of insurance billing, coverages, remittance review, and coordination of benefits
- Subject matter expert with strong communication skills required for identifying training needs, conducting peer education and training, with ability to answer process questions and completes and records quality assurance audits
- Perform general duties such as act as a project lead to drive team collaboration, conducts DIBS meetings and facilitates in person account review meetings, relays proper account status updates in daily inhouse and Client accountability calls, runs, works, and records various reports and monitors work queue assignments
Minimum years and type of experience:
- High School Diploma, GED, or Equivalent Experience
- 3-5 years of experience in healthcare industry, interacting with patients regarding hospital financial issues.
Other knowledge, skills, and abilities preferred:
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Minimum Years and Type of Experience: 3+ years' experience interacting with patients regarding hospital financial issues.
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Superior customer service skills and ability to communicate with all levels effectively.
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Accustomed to substantial computer use and possesses a strong ability to multi-task required.
Certifications:
- CRCR within 9 months of hire (Company Paid)
Join an award-winning company
Three-time winner of “Best in KLAS” 2020-2022
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards
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Innovation
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Work-Life Flexibility
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Leadership
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Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
- Associate Benefits – We offer a 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.
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Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
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Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
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Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact [email protected].
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.
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Date Posted
09/20/2024
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