Eligibility Insurance Specialist

About the role

The Insurance Specialist is tasked with identifying candidates for the Health Insurance Premium Payment (HIPP) program. In addition to assisting with identifying the potential candidates, other responsibilities will include assistance with enrollment, working closely with family and the agency through the enrollment process; identify all sources for payment, documenting accounting system including progress notes and all required activities to ensure accurate reporting and following the case through the approval process.

This individual will work closely with the EES onsite teams to coordinate the patient’s application process. The role is based at Valley Baptist, with a Monday-Friday 8a-4:30p schedule, and requires Spanish language proficiency.

Responsibilities

• Performs an in-depth analysis of all inventory identified as eligible, including review of patient’s demographics, payor data review, and understanding payor methodology.
• Develops a working relationship with patient and/or family through application process for completion and follow-through of each case.
• Works closely with State agencies to facilitate case approval, filing appeals as necessary, and contacts patient’s employer HR department and/or insurance company to gain knowledge on insurance fee structure.
• Secures all required forms and data for the program, develops working relationship with MECS Director, Social Workers and Case Management, PA Directors as needed to communicate progress on the application status.
• Follows up on all assigned inventory timely according to documentation and follow-up guidelines, and documents thoroughly to ensure accounts are captured correctly through reporting.
• Works closely with management team to continue the development of the program.

Requirements

• Working familiarity with the rules and regulations pertaining to Federal, State and County programs.
• P/C systems literate, including Windows, Microsoft Outlook, Excel, and Word programs.
• Ability to work independently, with excellent oral and written communication skills and a clear understanding of the English language.
• Detail-oriented, with strengths in dealing with multiple facilities, supervisors, and hospital platforms.
• Ability to prioritize and manage multiple tasks with efficiency.
• Valid Driver's License and auto insurance.

Qualifications

A High School Diploma or equivalent is required, with a minimum of 2 years of work experience in the medical field and knowledge of medical terminology.

Skills

The ideal candidate will have strong analytical, communication, and organizational skills, with the ability to work in a fast-paced environment and prioritize multiple tasks.

Physical Demands and Work Environment

The role requires the ability to work in a sitting position, use a computer, and answer telephone, with approximately 10% travel required. The work environment is an office or hospital setting.