Medicaid Benefits & 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

Job summary

Ensemble Health Partners is seeking candidates for an on-site role at HSHS - St. John's Hospital in Springfield, IL to assist uninsured and under-insured patients with Medicaid eligibility and related revenue cycle tasks.

The role emphasizes clear patient communication, accurate application processing, and collaboration with Medicaid partners. A high school diploma or GED is required, with preferred post-secondary education or experience; 1–2 years in healthcare is expected.

Qualifications

• 1-2 years of experience in healthcare industry, interacting with patients regarding hospital financial issues.
• 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.
• 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.
• High School Diploma or GED. Combination of post-secondary education and experience will be considered in lieu of degree.

Responsibilities

• Reviewing all 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 documents that must accompany the application.
• Following submitted applications to determination point, updating applicable 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 all state and federal program requirements; shares information with colleagues and supervisors.
• Developing and maintaining proactive working relationship with county/state/federal Medicaid caseworker partners, working collaboratively with other revenue cycle departments and associates.
• Other job duties as assigned.

Skills

Healthcare experience

AI openness

Education

High School Diploma or GED

Post-secondary education considered

Job description

Ensemble Health Partners is seeking candidates for an on-site role at HSHS - St. John's Hospital in Springfield, IL to assist uninsured and under-insured patients with Medicaid eligibility and related revenue cycle tasks.

The role emphasizes clear patient communication, accurate application processing, and collaboration with Medicaid partners. A high school diploma or GED is required, with preferred post-secondary education or experience; 1–2 years in healthcare is expected.