Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or Financial Assistance program
Assists with application processes to facilitate accurate and appropriate submissions
Follows-up on submitted applications to ensure timely billing or adjustment processing
Reviewing referred uninsured/under-insured patients for program eligibility opportunities
Initializing and coordinating the application process to facilitate accurate and appropriate submissions
Effectively communicating with the patient to obtain necessary documents
Following submitted applications to determination point, updating insurance information and ensuring timely billing or adjustment posting
Documenting all relevant actions and communication steps in assigned patient accounting systems
Maintaining working knowledge of state and federal program requirements and sharing information with colleagues

1-2 years of experience in healthcare industry
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
High School Diploma or GED preferred, combination of post-secondary education and experience will be considered in lieu of degree
Certifications: CRCR within 9 months of hire (Company Paid)

Public Benefit Specialist

Key skills