Medicaid Eligibility Advisor
Company: Hospital Corporation of America
Location: Jacksonville, Florida
Posted: November 30, 2017
Reference ID: 26838-141231
Do you have a passion for healthcare and helping others? Do you enjoy working in a fast-paced, patient-centered environment? Jump-start your career in our Government Programs department and apply today to be a Patient Benefit Advisor.
We serve and enable those who care for and improve human life in their communities.
Parallon, a division of HCA, is an industry-leading provider of patient financial and revenue cycle services to acute care providers across the United States. We are dedicated to our values and passionate about finding future leaders for our fast-growing divisions. Although we are the largest healthcare provider in the world and experts and leaders in revenue cycle services, we maintain a people-first culture and sense of community.
As a Patient Benefit Advisor, you would be responsible for interviewing and assisting uninsured/underinsured patients with eligibility for Medicaid or Social Security Disability.
GENERAL SUMMARY OF DUTIES - Interviews and assists uninsured/underinsured patients with eligibility for Medicaid or Social Security Disability.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
• Reviews all referred uninsured patients for potential state and federal assistance programs.
• Assists with application process to facilitate possible assistance approval and timely billing.
• Visits with patient in hospital or outside location (i.e., residence, employer, etc.) to finalize documents vital to assistance approval.
• Submits inpatient applications directly to social services, follows application status to completion, updates account with verified insurance information and ensures timely billing.
• Maintains knowledge of all state and federal program requirements; shares information with coworkers and supervisors.
• Reviews all inpatient admissions to identify and ensure accurate record of all Medicaid primary and secondary eligible days. If application denied, assists patients with appeals process as needed.
• Works collaboratively with various departments: Case Management, Admissions, Finance, as well as Physician offices and clinics.
• Maintains log of all Medicaid or Social Security Disability (SSI) pending accounts to ensure all accounts are tracked and completed.
• Maintains log and documentation for all Medicaid eligible days identified, but not registered in Meditech as Medicaid to ensure accurate reporting on the Medicare cost report.
• Serves as a backup for Financial Counselor position, reviewing in-house patients to ensure insurance coverage information and/or financial situation documented in Meditech is accurate.
• Exhibits ethical behavior; performs job duties in compliance with all Regulatory Agencies, as well as, Corporate and Hospital Policies.
• Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
• Other duties as assigned
KNOWLEDGE, SKILLS & ABILITIES
• Knowledge of state and federal assistance program requirements preferred.
• Experience interacting with local Social Services personnel or departments.
• Strong effective communication skills; verbal, written and negotiating skills.
• Bilingual/Spanish preferred (may be required depending on facility).
• Ability to read, analyze and interpret state and federal regulations.
• Strong customer service skills.
• Strong problem-solving skills. Ability to anticipate problems and work effectively to resolve issues.
• Knowledge of medical terminology and computer literate.
• High school diploma or GED required
• At least two years' work experience interacting with customers and patients regarding financial issues, financial eligibility experience preferred.
CERTIFICATE/LICENSE - N/A
PHYSICAL DEMANDS/WORKING CONDITIONS - Requires prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports. Requires lifting papers or boxes up to 25 pounds occasionally. Work is performed in an office environment. Work may be stressful at times.
Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations.