Revenue Cycle Specialist

3 days ago


Lewiston, Maine, United States Ensemble Health Partners Full time
About Ensemble Health Partners

At Ensemble Health Partners, we are a leading provider of technology-enabled revenue cycle management solutions for health systems. Our mission is to empower our people to challenge the status quo and make a meaningful difference in the lives of our patients.

Job Description

We are seeking a highly motivated Revenue Cycle Specialist to join our team. As a key member of our revenue cycle team, you will play a vital role in ensuring that our patients receive the best possible care. Your primary responsibility will be to interview uninsured/under-insured patients to determine their eligibility for state Medicaid benefits or our financial assistance program.

You will be responsible for initializing and coordinating the application process to facilitate accurate and timely submissions. This will involve effectively communicating with patients to obtain necessary documents and following up on submitted applications to ensure timely billing or adjustment processing.

In addition to your technical skills, you will also be expected to develop and maintain proactive working relationships with county/state/federal Medicaid caseworker partners and other revenue cycle departments and associates.

Key Responsibilities
  • Review uninsured/under-insured patients for program eligibility opportunities and initialize the application process
  • Effectively communicate with patients to obtain necessary documents
  • Follow up on submitted applications to determine eligibility and ensure timely billing or adjustment processing
  • Document all relevant actions and communication steps in assigned patient accounting systems
  • Maintain a working knowledge of state and federal program requirements and share information with colleagues and supervisors
  • Develop and maintain proactive working relationships with Medicaid caseworker partners and other revenue cycle departments and associates
Requirements

To be successful in this role, you will need to have:

  • 1-2 years of experience in the healthcare industry, interacting with patients regarding hospital financial issues
  • A High School Diploma or GED, with a combination of post-secondary education and experience considered in lieu of degree
  • CRCR certification within 9 months of hire (company-paid)
Preferred Qualifications

We are also looking for candidates with:

  • Understanding of Revenue Cycle processes, including admission, billing, payments, and denials
  • Comprehensive knowledge of patient insurance processes for obtaining authorizations and benefits verification
  • Knowledge of Health Insurance requirements and medical terminology or CPT/procedure codes
  • Patient Access experience with managed care/insurance and Call Center experience highly preferred
Benefits

We offer a comprehensive benefits package, including:

  • Healthcare
  • Time off
  • Retirement
  • Well-being programs

We are also committed to the growth and development of our associates, offering:

  • Professional certification relevant to your field
  • Tuition reimbursement
  • Quarterly and annual incentive programs
About Our Company

Ensemble Health Partners is an award-winning company, recognized for our commitment to excellence in the healthcare industry. We have been named a Top Workplaces USA Award winner and a Top Workplaces Healthcare Industry Award winner.

We are proud to offer a work environment that values collaboration, growth, and innovation. Our associates are empowered to challenge the status quo and make a meaningful difference in the lives of our patients.



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