Medicaid Eligibility Specialist

3 months ago

Port Orange, United States HealthFund Solutions Full time
Job DescriptionJob Description

At HealthFund Solutions, we are an advocate for uninsured patients and a partner to hospitals and healthcare providers.

With decades of experience in the healthcare field, we observed a rising need to help a percentage of the American population that continues to grow every day—those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need and get back on their feet.

Reporting to the Regional/Eligibility Manager, the Caseworker Medicaid and Disability will coordinate activities to ensure that Medicaid, Social Security, County Indigent, or other types of eligible funding for healthcare services are received for patients. This includes assisting the patients and others (family members) to complete forms, applications, and other paperwork. Caseworkers will screen patients bedside and by phone to see if they qualify for Federal, State and County programs which include Medicaid, Disability and ACA Marketplace Insurance.

 

Responsibilities:

  • Complete daily screenings bedside and by phone
  • Make appropriate referrals to Sponsorship
  • File appropriate applications
  • Follow-up on previously filed applications until approved/denied
  • Collect all the required/pending documentation
  • Submit required documentation
  • Request/file appropriate hearings if needed
  • Communicate with patients and hospital staff
  • Collect and review patient information to determine patient’s eligibility
  • Send referrals to Sponsorship
  • Prepare documents, review for accuracy and completeness
  • Provide technical assistance with the different programs HFS provides
  • Maintain and/or create files
  • Manage caseload
  • Retrieve, sustain and communicate all designated reports
  • Maintain database
  • Develop and retain a professional relationship with HFS staff and hospital staff
  • May require working evenings, weekends, and some holidays
  • Other duties assigned by Management

 

Requirements:

  • Highschool required
  • Associate’s degree preferred
  • Thorough knowledge and understanding of Florida Medicaid eligibility criteria
  • Full Cycle Florida Medicaid application experience preferred
  • Disability application experience preferred both Medicaid and Social Security
  • Ability to maintain and respect confidentiality and HIPAA guidelines
  • Highly effective in working objectively with a diverse group of people and must demonstrate communication, organizational, administrative and time managers ability to read and comprehend simple instructions
  • Ability to self-direct work
  • Effective stress coping skills
  • Bi-lingual with Spanish preferred
  • Ability to communicate clearly and concisely is required
  • Excellent verbal and written communication skills
  • May require working evenings, weekend, and some holidays
  • Experience with Florida Family Medicaid, Medicaid Disability, Social Security Disability and filing DCF applications preferred
  • Florida DCF experience a plus

 

Physical Abilities:

While performing the duties of this job

  • Ability to sit for long periods of time entering data into the computer
  • Ability to occasionally lift up to 10 pounds
  • Ability to concentrate and stay on task for long periods of time

NOTE: This job description is not intended to be all-inclusive. Employee may perform other duties as required to meet the ongoing needs of the organization.

 

Benefits:

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Short Term and Long-term disability
  • Term Life Insurance
  • Critical Care Insurance
  • 401K with company match
  • Paid Time Off

Please note that as we are vendors to several hospital systems. All onsite hospital positions are required to have the COVID vaccination completed prior to start date. If you choose not to vaccinate, you are required to provide a fully executed medical or religious exemption form prior to your start date. Upon approval of that exemption, you would be required to submit to weekly COVID testing. Be aware, that this policy could change at any time.

We are an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

The successful candidate will be required to complete the Form I-9 and that information will be verified using the E-Verify system. E-Verify is operated by the Department of Homeland Security in partnership with the Social Security Administration to verify employment eligibility.

Any candidate offered a position will be required to pass pre-employment screenings which include a national background check and a 12-panel drug screen.

HealthFund Solutions is a Drug -Free Workplace.

Company DescriptionAt HealthFund Solutions, we are advocates for uninsured patients and a partner to hospitals and healthcare providers.

With decades of experience in the healthcare field, we observed a rising need to help a percentage of the American population that continues to grow every day—those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need and get back on their feet.Company DescriptionAt HealthFund Solutions, we are advocates for uninsured patients and a partner to hospitals and healthcare providers.\r
\r
With decades of experience in the healthcare field, we observed a rising need to help a percentage of the American population that continues to grow every day—those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need and get back on their feet.

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