Inpatient Eligibility Specialist

Employment Qualifications

• Minimum Education: High School Diploma or GED
• Minimum Years and Type of Experience: 1-2 years of experience in the healthcare industry, social work, or case management environment, interacting with patients regarding financial concerns, working with self-pay, underinsured, or a compromised population in a face-to-face customer service capacity.
• Preferred Knowledge, Skills and Abilities:
  • Understanding of Revenue Cycle functions including billing, payments, denials, authorizations, and benefit verifications.
  • Knowledge of health insurance requirements.
  • Knowledge of medical terminology.
  • Experience with managed care/insurance knowledge.
  • Ability to comprehend various state Medicaid plan qualifications and communicate patient benefits clearly and effectively to those most likely to benefit.
  • Good math skills and ability to identify best program for an applicant out of those available.
  • Complete written applications with patients to submit to state agencies and ensure the supporting documents will be provided timely.

Position Details

• Oversight of signatures on State forms and clear communication regarding the additional documents the patient will need to provide to complete the application is central to this role.
• This position is in the facility and is not remote.