Medicaid Eligibility Project Coordinator

  • Company: Hospital Corporation of America
  • Location: Las Vegas, Nevada
  • Posted: December 20, 2017
  • Reference ID: 26588-139813

Position Summary: Primary responsibilities are in the areas of Implementation and Support. The Operations Coordinator is responsible for administering the mandated training curriculum; and for sustaining a supportive role for project implementation as well as existing office operations. The Operations Coordinator is required to fulfill short term and extended, local and long distance travel assignments. Must maintain and perform the basic duties of the PBA position. The Operations Coordinator is responsible for affecting ongoing quality, productivity, and efficiency by applying a proactive approach to all daily operational duties.
Essential Job Functions:
The Operations Coordinator must be able to travel 80% to 90% of their time and be able to front all expenses to be reimbursed by Parallon. Previous eligibility experience required. Each employee is required to fulfill obligations regarding all daily operational duties; and to adhere to all operational policies and procedures. Employees shall work professionally with patients, hospital employees, agency caseworkers and their respective colleagues.
  • Employees shall treat each and every patient, regardless of balance amount, with the utmost dignity and respect.
  • Employees shall screen and evaluate referred self-pay patients for existing insurance coverage, federal and state assistance programs, or hospital charity applications.
  • Employees are to secure authorization to represent the patient and complete the application for federal or state programs.
  • Employees must be able to complete and file applications.
  • Employees are to obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination.
  • Employees are to maintain proper follow-up through the use of daily cycles and by calling government caseworkers to assure all mandated information has been received by the agency to verify application status and progress.
  • Employees must document progress notes to the patient's file and the hospital computer system so that hospital personnel can easily identify the progress and status of each referral.
  • Employees must demonstrate proper and effective case management skills.
  • Adhere to work schedules as mandated by supervisor.
  • Maintain work flow in a consistent and timely manner.

  • Knowledge : Working knowledge of the medical billing process and a strong understanding of medical terminology or familiarity with the collections industry strongly preferred. Associate's degree from a two-year college in accounting or other business related acumen; or an equivalent combination of education and experience.
  • Experience: A minimum of at least 1 year experience in customer service with frequent telephone contact. Experience working with database software (preferably in a SQL environment); spreadsheet software and word processing software. Exposure to the collections or similar industry preferred.
  • Competencies: Demonstrated analytical, communication and problem solving skills and the ability to act/decide accordingly. Ability to collect, synthesize and research complex or diverse information. Exceptional customer service and the ability to plan organize and exercise sound judgment.
  • Disclaimer: The above statements are intended to describe the general nature and level of work being performed. They are not intended to be an exhaustive list of responsibilities, duties and skills required.

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