Public Benefit Specialist

**This position is located On-Site at Tower - Reading Hospital in West Reading, PA**

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.
• Bilingual speaking proficiency in Spanish/English

Minimum Education:

• High School Diploma or GED. Combination of post-secondary education and experience will be considered in lieu of degree.

Certifications:

• CRCR Required within 9 months of hire (Company Paid)