Eligibility Screener

You would be working in a local hospital assisting patients with applications for third-party resources including state aide.

Principal Responsibilities

• Screen patients and/or patient representatives to determine eligibility for Third Party resources.
• Educate patients and patient representatives of the eligibility requirements, application process, and verification requirements for applicable programs.
• Maintain a professional relationship with the patient and governmental agencies to ensure cooperation and compliance.
• Document pertinent patient information and all work activity in the appropriate systems dictated by company policies and procedures.
• Ensure accounts are processed in accordance to Eligibility Program standards, Client expectations, and all applicable federal and state regulations guidelines.
• Maintain the appropriate level of work activity according to work standards and establish work processes to ensure timely certification for eligibility programs.
• Retrieve and forward requested records and information, including medical records, insurance policy information, remittance advice, and itemized statements, to appropriate parties.
• Analyze, distribute, and follow-up on special requests and adjustments with hospital personnel.
• Maintain consistent proactive communication with the patient or patient representative throughout the eligibility process, keeping the patient informed of the account progress.
• Communicate effectively with physicians, case managers, social workers, and hospital business office staff on a daily basis to ensure questions are answered and issues are addressed.
• Educate patients and patient representatives of the eligibility requirements, application process, and verification requirements for applicable programs.
• Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties.
• Perform other duties as assigned by management.

Requirements

• High School diploma or General Educational Development (GED) certificate or equivalent in relevant work experience desired.
• Previous healthcare coverage/eligibility experience preferred.
• Proficient personal computer skills including Microsoft Office.
• Ability to maintain the highest level of confidentiality.
• Bilingual (Spanish) a plus.
• Excellent interpersonal, written, and oral communication skills.
• Willing and able to work inside of a hospital including visiting hospital rooms to complete tasks which requires a vaccination regimen and drug screening
• Ability to work in a team fostered environment.
• Ability to work in a multi-tasked environment.
• Ability to prioritize and organize work.
• Ability to adapt to a flexible schedule.

Work Environment

• Office environment within a local hospital
• Ability to lift and/or move 20 pounds with or without accommodation.
• Heavy walking is required

Behaviors

• Enthusiastic: Shows intense and eager enjoyment and interest
• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

Motivations

• Flexibility: Inspired to perform well when granted the ability to set your own schedule and goals
• Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization