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 the eligibility process and benefits of Medicaid coverage.
• Oversee and secure signatures on State forms.
• Communicate required additional documents for application completion.
• Complete written applications with patients for submission to state agencies.
• Ensure supporting documents are provided in a timely manner.

Requirements

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

Skills

• Understanding of Revenue Cycle functions (billing, payments, denials, authorizations, and benefit verifications).
• Knowledge of health insurance requirements and medical terminology.
• Experience with patient access and managed care/insurance knowledge.
• Ability to comprehend state Medicaid plan qualifications and communicate benefits clearly.
• Good math skills to identify the best program for applicants.
• Strong face-to-face communication and customer service skills.
• Background in assisting customers or patients with document completion and applications.
• Knowledge of medical expenses, associated bills, and patient insurance.
• Ability to multitask and learn complex state program requirements.
• Bias for action, patient/consumer-focused, entrepreneurial mindset, and commitment to excellence and service.

Benefits

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