Inpatient Eligibility Specialist

About the role

Interviews uninsured/under-insured patients in a hospital setting to determine eligibility for State Medicaid benefits and Financial Assistance.

Responsibilities

• Absorbing patients in hospital rooms to assist with the application processes to ensure accurate and appropriate application submission.
• Building a positive relationship with the patient and communicating the eligibility process and the benefits of having Medicaid coverage.
• Oversight of signatures on State forms and clear communication regarding the additional documents the patient will need to provide to complete the application.

Requirements

• 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.
• Proactively explaining complicated programs.

Qualifications

• Understanding of Revenue Cycle functions including billing, payments, denials, authorizations, and benefit verifications.
• Knowledge of health insurance requirements.
• Knowledge of medical terminology.
• Patient access 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 the 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.
• Customer service ability, strong face to face communication skills, background working with customers or patients on document completion and applications, knowledge of medical expenses and associated bills, knowledge of patient insurance, ability to multitask, ability to learn complex state requirements for programs and explain to patients, bias for action, patient/consumer-focused, entrepreneurial and commitment to excellence and service.

Benefits

• Outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
• Opportunity to grow and contribute to the future of healthcare through innovation, technology, and compassion.