Medicaid Eligibility & Benefit Specialist (On-Site NM)

Ensemble Health Partners; New Mexico; On-site; USD 26,000 - 28,000; Full time

Benefits offered by this job

Bonus incentives

Certifications paid

Tuition reimbursement

Comprehensive benefits

Career advancement

Job summary

Ensemble Health Partners is seeking a on-site Eligibility Specialist at Ardent - Valencia County Hospital in Los Lunas, NM. You will interview uninsured/under-insured patients to determine Medicaid eligibility, assist with applications, and follow up to ensure timely billing or adjustments.

Minimum 1–2 years in healthcare patient interactions, with strong revenue cycle knowledge and insurance verification experience.

Qualifications

• 1-2 years of experience in healthcare industry, interacting with patients regarding hospital financial issues.
• 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.

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.

Job description

Ensemble Health Partners is seeking a on-site Eligibility Specialist at Ardent - Valencia County Hospital in Los Lunas, NM. You will interview uninsured/under-insured patients to determine Medicaid eligibility, assist with applications, and follow up to ensure timely billing or adjustments.

Minimum 1–2 years in healthcare patient interactions, with strong revenue cycle knowledge and insurance verification experience.