Public Benefit Specialist

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

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to‑to‑end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results. The Opportunity: CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $18.65 - $20.50/hr. based on experience This position is located On-Site at Ardent - Valencia County Hospital in Los Lunas, NM 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.

Essential Job Functions

• 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

Employment Qualifications

• Minimum years and type of experience: 1-2 years of experience in healthcare industry, interacting with patients regarding hospital financial issues.
• Other knowledge, skills, and abilities preferred: 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.
• 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.

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.

Awards

• Five‑time winner of “Best in KLAS” 2020‑2022, 2024‑2025
• Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021‑2024
• 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019‑2024
• Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
• Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022‑2023
• Energage Top Workplaces USA 2022‑2024
• Fortune Media Best Workplaces in Healthcare 2024
• Monster Top Workplace for Remote Work 2024
• Great Place to Work certified 2023‑2024

Culture & Benefits

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well‑being programs.
• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Equal Employment Opportunity

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.

Eligibility and Workplace

Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered. Individuals may reapply when located within the United States.

Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact [e-mail].

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job‑related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.

If you are a passionate, dedicated and experienced revenue cycle, consulting or finance professional and seek career and personal growth, we would love to hear from you. We believe we foster an environment where talented individuals can excel and shine. Our team believes that people are the most important part of our success and that when we take care of our people, they pay it forward by providing our clients with excellent results and world‑class service.