Medicaid Eligibility & Patient Access Specialist

Ensemble Health Partners; Atlanta (GA); On-site; USD 19,000 - 30,000; Full time

Benefits offered by this job

Bonus incentives

Paid certifications

Tuition reimbursement

Comprehensive benefits

Career advancement

Job summary

Ensemble Health Partners seeks a motivated Healthcare Access Specialist to determine Medicaid eligibility for uninsured patients and guide the application process on-site at our Atlanta, GA location. You will coordinate submissions, verify insurance details, and ensure timely billing in our revenue cycle workflow.

The role requires 1-2 years in healthcare, knowledge of insurance requirements, and CPT/medical terminology.

Qualifications

• 1-2 years of experience in healthcare industry, interacting with patients regarding hospital financial issues.
• CRCR certification within 9 months of hire (Company Paid).
• Understanding of Revenue Cycle including admission, billing, payments and denials.
• 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.

Responsibilities

• Interviews uninsured/under-insured patients to determine eligibility for a state Medicaid benefit or location Financial Assistance program.
• Assists with application processes to facilitate accurate and appropriate submissions.
• Follows-up on submitted applications to insure timely billing or adjustment processing.
• 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

Patient communication

Revenue cycle knowledge

Insurance verification

Call center experience

Healthcare industry experience

Education

High School Diploma or GED

Job description

Ensemble Health Partners seeks a motivated Healthcare Access Specialist to determine Medicaid eligibility for uninsured patients and guide the application process on-site at our Atlanta, GA location. You will coordinate submissions, verify insurance details, and ensure timely billing in our revenue cycle workflow.

The role requires 1-2 years in healthcare, knowledge of insurance requirements, and CPT/medical terminology.