Public Benefit Specialist

Jobtailor; Columbia (SC); On-site; USD 42,000 - 60,000; Full time

Job summary

Jobtailor in Columbia, SC seeks a healthcare access specialist to determine Medicaid eligibility and assist with applications. You will coordinate submissions, follow up for timely billing and adjustments, and review referrals for program opportunities.

Role requires knowledge of revenue cycle, insurance verification, and CPT codes, plus potential CRCR certification within 9 months. Must reside in the U.S. and have a high school diploma or GED.

Qualifications

• 1–2 years of experience in healthcare interacting with patients about hospital finances.
• Understanding of revenue cycle: admission, billing, payments, and denials.
• Knowledge of patient insurance processes for authorizations and verification.
• Knowledge of health insurance requirements.
• Knowledge of CPT codes or medical terminology.
• Patient Access experience with managed care/insurance and call center preferred.
• Openness to innovation, including AI.
• High School Diploma or GED.
• Combination of post-secondary education and experience may substitute degree.
• CRCR certification within 9 months of hire.
• Must reside in and be authorized to work in the United States.

Responsibilities

• Interview uninsured and under-insured patients to determine Medicaid eligibility.
• Assist with application processes to facilitate submissions.
• Follow up on submitted applications for timely billing/adjustments.
• Review referred patients for eligibility and coordinate applications.
• Communicate with patients to obtain documents for applications.
• Track applications through determination and update insurance info.
• Document actions in patient accounting systems.
• Maintain knowledge of state and federal program rules.
• Develop relations with Medicaid caseworkers and partners.
• Collaborate with revenue cycle departments and associates.
• Perform other duties as assigned.

Skills

Patient Eligibility Determination

Revenue Cycle Management

Insurance Verification

CRCR Certification

CPT Codes Knowledge

Education

High School Diploma or GED

Combination of post-secondary education and experience

Tools

Patient Accounting Systems

Job description

• Interview uninsured and under-insured patients to determine eligibility for state Medicaid benefits or local financial assistance programs


• Assist with application processes to facilitate accurate and appropriate submissions


• Follow up on submitted applications to ensure timely billing or adjustment processing


• Review referred patients for program eligibility opportunities and coordinate application processes


• Communicate with patients to obtain documents required for applications


• Follow submitted applications through determination, update insurance information, and ensure timely billing or adjustment posting


• Document relevant actions and communication steps in patient accounting systems


• Maintain knowledge of state and federal program requirements and share information with colleagues and supervisors


• Develop and maintain working relationships with county, state, and federal Medicaid caseworker partners


• Collaborate with revenue cycle departments and associates


• Perform other duties as assigned

Requirements

• 1–2 years of experience in the healthcare industry interacting with patients regarding hospital financial issues


• Understanding of revenue cycle, including admission, billing, payments, and denials


• Knowledge of patient insurance processes 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


• Openness to innovation, including AI


• High School Diploma or GED


• Combination of post-secondary education and experience will be considered in lieu of degree


• CRCR certification within 9 months of hire


• Must reside in and be authorized to work within the United States

Core Competencies

Demonstrates expertise in patient eligibility determination for Medicaid and financial assistance programs, with a strong understanding of revenue cycle processes, including billing and insurance verification. Maintains effective communication and collaboration with patients and healthcare partners to ensure timely application processing and compliance with state and federal requirements.

Highest-signal resume keywords

• Patient Eligibility Determination


• Revenue Cycle Management


• Insurance Verification


• CRCR Certification


• Medical Terminology Knowledge

Hard Skills

• Patient Access Experience


• Application Processing


• Billing and Payments


• CPT Codes Knowledge


• Denials Management

Soft Skills

• Communication


• Collaboration


• Openness to Innovation

Certifications & Qualifications

• CRCR Certification

Industry Keywords

• Healthcare Industry


• Medicaid


• Financial Assistance Programs


• Managed Care


• Call Center Experience

Tools & Technologies

• Patient Accounting Systems