Medicaid Eligibility Advocate

Job Summary and Qualifications

The Bilingual Medicaid Eligibility Advocate is responsible for conducting eligibility screenings, assessments, and counseling patients on insurance benefits and co-payments. The role involves liaising between patients, hospitals, and governmental agencies, ensuring timely processing of applications and maintaining accurate records.

• Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, or hospital charity applications.
• Re-verify benefits and obtain authorization and/or referral after treatment plan discussion, prior to initiation of treatment.
• Absorb and enter legally relevant medical evidence, physician statements, and all other required documentation for eligibility determination.
• Complete and file applications, initiate and maintain proper follow-up with patients and government agency caseworkers to ensure timely processing and completion of all mandated applications and accompanying documentation.
• Ensure all insurance, demographic, and eligibility information is obtained and entered into the system accurately.
• Document progress notes to the patient’s file and the hospital computer system.
• Participate in ongoing, comprehensive training programs as required.
• Follow policies and procedures to contribute to the efficiency of the office.
• Cover and assist with other office functions as requested.
• Make field visits as necessary and require reliable personal transportation.

Qualifications

• Associate degree preferred.
• Minimum of one-year related experience preferred, preferably in healthcare.
• Relevant education may substitute experience requirement.
• Bilingual skills are required.

Benefits

Northeastern Nevada Regional Hospital offers a comprehensive benefits package that includes:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health, and telemedicine services.
• Wellbeing support, including free counseling and referral services.
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
• Tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.

Note

Eligibility for benefits may vary by location. Please refer to the benefits section for details specific to your area.