Onsite Springfield - Inpatient Eligibility Specialist

About the Role

Interview uninsured or under-insured patients in a hospital setting to determine eligibility for State Medicaid benefits and Financial Assistance. Assist patients in hospital rooms with application processes to ensure accurate and appropriate submission. Build positive relationships with patients and communicate the eligibility process and benefits of Medicaid coverage. Oversee signatures on State forms and clearly communicate additional documents patients need to provide to complete the application.

Responsibilities

• Interview patients to assess eligibility for State Medicaid and Financial Assistance programs.
• Assist patients with application processes in hospital rooms.
• Explain complicated programs and eligibility requirements to patients.
• Ensure accurate completion of written applications for submission to state agencies.
• Communicate required supporting documents and deadlines to patients.
• Build trust and maintain positive relationships with patients.

Requirements

• High School Diploma or GED (required).
• 1-2 years of experience in healthcare, social work, or case management, specifically interacting with patients regarding financial concerns.
• Experience working with self-pay, underinsured, or compromised populations in a face-to-face customer service capacity.

Skills

• Understanding of Revenue Cycle functions (billing, payments, denials, authorizations, benefit verifications).
• Knowledge of health insurance requirements and medical terminology.
• Experience with patient access, managed care, or insurance processes.
• Ability to comprehend state Medicaid plan qualifications and communicate benefits clearly.
• Strong math skills to identify the best program for applicants.
• Customer service and face-to-face communication skills.
• Ability to multitask and learn complex state program requirements.
• Patient-focused, proactive, and entrepreneurial mindset.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Tuition support.
• Matched retirement plans for team members working 32+ hours per pay period.