Medicaid Eligibility Advocate

About This Role

The Medicaid Eligibility Advocate conducts eligibility screenings, assesses patient financial requirements, and counsels patients on insurance benefits and co-payments, acting as a liaison between patients, the hospital, and governmental agencies. This role is actively involved in case management.

Responsibilities

• 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 a treatment plan has been discussed, prior to initiation of treatment
• Obtain legally relevant medical evidence, physician statements, and all other documentation required for eligibility determination
• Complete and file applications
• Initiate and maintain proper follow-up with the patient 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 and assist with other office functions as requested
• Make field visits as necessary and have reliable personal transportation readily available

Qualifications

• Associate’s degree preferred
• Minimum one-year related experience preferred, preferably in healthcare

Nice to Have

• Minimum one-year related experience, preferably in healthcare

Benefits