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Medicaid Eligibility Advocate
About the position
The Medicaid Eligibility Advocate screens and evaluates patients for existing insurance coverage, federal and state assistance programs, and hospital charity applications. The role verifies benefits and obtains authorizations or referrals after the treatment plan is discussed and before treatment begins. It also gathers the signatures and medical and other documentation needed to determine eligibility, completes and files applications, and follows up with patients and government agency caseworkers to support timely processing. The advocate ensures insurance, demographic, and eligibility information is accurately entered into the system and documents progress in patient files and the hospital computer system. The position participates in ongoing training, follows office policies and procedures, and assists with other office functions as requested. Field visits may be necessary, so reliable personal transportation must be readily available. The role is work from home and has a Monday through Friday schedule from 8:00 a.m. to 4:30 p.m.
Responsibilities
- Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, and hospital charity applications.
- Re-verify benefits and obtain authorization and/or referrals after the treatment plan has been discussed and before treatment begins.
- Ensure that all necessary forms are signed.
- Obtain legally relevant medical evidence, physician statements, and other documentation needed for eligibility determinations.
- Complete and file applications.
- Follow up with patients and government agency caseworkers to ensure timely processing and completion of applications and supporting documentation.
- Obtain and accurately enter insurance, demographic, and eligibility information into the system.
- Document progress notes in patient files and the hospital computer system.
- Participate in ongoing, comprehensive training programs.
- Follow policies and procedures to contribute to office efficiency.
- Cover and assist with other office functions as requested.
- Make field visits as necessary.
Requirements
- Reliable personal transportation readily available for necessary field visits.
Nice-to-haves
- Associate’s degree preferred.
- Minimum one year of related experience preferred, preferably in healthcare.
- Relevant education may substitute for the experience requirement.
Benefits
- Comprehensive medical, prescription drug, dental, vision, behavioral health, and telemedicine benefits.
- Wellbeing support, including free counseling and referral services.
- Paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
- 401(k) plan with a 100% match on 3% to 9% of pay, based on years of service.
- Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
- Tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
- Fertility and family-building benefits and adoption assistance.
- Life insurance and supplemental health protection plans.
- Auto and home insurance, legal counseling, identity theft protection, and consumer discounts.
