Onsite Medicaid Eligibility Specialist — Tuition Reimbursement

Ensemble Health Partners; West Reading (Berks County); 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 a on-site Eligibility Specialist at Reading Hospital in West Reading, PA. The role focuses on reviewing uninsured/under-insured patients for Medicaid eligibility and assisting with the application process to ensure accurate and timely submissions.

You will follow up on applications, coordinate with county/state programs, and document all actions in the patient accounting systems.

Qualifications

• 1-2 years of experience in healthcare interacting with patients regarding hospital financial issues.
• Understanding of Revenue Cycle including admission, billing, payments and denials.
• Knowledge of patient insurance process for obtaining authorizations and benefits verification.
• Knowledge of Health Insurance requirements; CPT/procedure codes.
• Call Center experience highly preferred.
• Bilingual proficiency in Spanish/English.

Responsibilities

• Interviews uninsured/under-insured patients to determine Medicaid/financial eligibility.
• Assists with application processes to facilitate submissions.
• Follows up on submitted applications to ensure timely billing/adjustments.
• Communicates with patients to obtain required documents.
• Updates insurance information and tracks submissions.
• Documents actions in patient accounting systems.
• Maintains knowledge of state/federal program requirements.
• Collaborates with Medicaid caseworkers and other revenue-cycle departments.

Skills

Bilingual Spanish/English

Revenue Cycle knowledge

Customer service

Call Center experience

Health insurance knowledge

Education

High School Diploma or GED

CRCR Certification

Job description

Ensemble Health Partners is seeking a on-site Eligibility Specialist at Reading Hospital in West Reading, PA. The role focuses on reviewing uninsured/under-insured patients for Medicaid eligibility and assisting with the application process to ensure accurate and timely submissions.

You will follow up on applications, coordinate with county/state programs, and document all actions in the patient accounting systems.