Medicaid Eligibility & Benefits Specialist

Ensemble Health Partners; Lewiston (ME); On-site; USD 27,000 - 30,000; Full time

Benefits offered by this job

Bonus incentives

Paid certifications

Tuition reimbursement

Comprehensive benefits

Career advancement

Job summary

Ensemble Health Partners is seeking an on-site Eligibility Specialist in Lewiston, ME, to screen uninsured or under-insured patients for Medicaid eligibility and assist with the application process. You will coordinate submissions, communicate required documents, and ensure timely billing or adjustments.

Knowledge of state/federal program rules and Medicaid coordination is essential. Ideal candidates have 1–2 years in healthcare revenue cycle, strong communication, and openness to AI-enabled

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.
• Minimum Education: High School Diploma or GED. Combination of post-secondary education and experience will be considered in lieu of degree.
• Certifications: CRCR within 9 months of hire. (Company Paid)

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

Inquisitive mindset

Patient communication

Team collaboration

Healthcare experience

Education

High School Diploma or GED

Job description

Ensemble Health Partners is seeking an on-site Eligibility Specialist in Lewiston, ME, to screen uninsured or under-insured patients for Medicaid eligibility and assist with the application process. You will coordinate submissions, communicate required documents, and ensure timely billing or adjustments.

Knowledge of state/federal program rules and Medicaid coordination is essential. Ideal candidates have 1–2 years in healthcare revenue cycle, strong communication, and openness to AI-enabled