Medicaid Access & Eligibility Specialist

Ensemble Health Partners; Springfield (IL); On-site; USD 26,000 - 28,000; Full time

Benefits offered by this job

Bonus incentives

Paid certifications

Tuition reimbursement

Comprehensive benefits

Career advancement

Associate benefits

Culture of collaboration

Job summary

Ensemble Health Partners is seeking a detail-oriented candidate to assist uninsured or under-insured patients with program eligibility and Medicaid/financial assistance applications. You will collect documents, coordinate submissions, and ensure timely billing adjustments.

The role emphasizes patient interaction and accurate processing. Qualifications include 1-2 years in healthcare, knowledge of revenue cycle processes, insurance verification, and CPA/CPT terminology familiarity.

Qualifications

• 1-2 years of experience in healthcare industry, interacting with patients regarding hospital financial issues.
• Must be inquisitive and open to innovation including AI to improve processes.
• Understanding of Revenue Cycle including admission, billing, payments and denials.
• Knowledge of patient insurance processes for obtaining authorizations and benefits verification.
• Knowledge of Health Insurance requirements.
• Knowledge of medical terminology or CPT codes.
• Patient Access experience with managed care/insurance and call center experience preferred.
• CRCR certification within 9 months of hire.

Responsibilities

• Review referred uninsured/under-insured patients for program eligibility and initiate submissions.
• Communicate with patients to obtain required documents for applications.
• Track applications to determination and ensure timely billing or adjustments.
• Document actions and communications in patient accounting systems.
• Maintain knowledge of state and federal program requirements and share with team.
• Build relationships with Medicaid caseworkers and collaborate with revenue cycle partners.
• Other duties as assigned.

Skills

Healthcare revenue cycle

Patient communication

Detail orientation

Adaptability

Education

High School Diploma or GED

Job description

Ensemble Health Partners is seeking a detail-oriented candidate to assist uninsured or under-insured patients with program eligibility and Medicaid/financial assistance applications. You will collect documents, coordinate submissions, and ensure timely billing adjustments.

The role emphasizes patient interaction and accurate processing. Qualifications include 1-2 years in healthcare, knowledge of revenue cycle processes, insurance verification, and CPA/CPT terminology familiarity.