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Bilingual Eligibility Services Representative
4 months ago
**Facilities are located in Plainfield and Elizabeth**
The Eligibility Services Representative is responsible for the provision of financial screening to qualify patients/guarantors for applicable federal, state, county, and local programs including but not limited to, charity care, Medicaid, ACA counseling. The qualifying individual will, investigate and assist in the identification/qualification process for all patients/guarantors on behalf of our clients as a business partner.
Responsibilities:
Application Process & Eligibility Determinations
- Review referrals and screen patients/guarantors for potential eligibility in appropriate federal/state/local programs.
- Advise applicants of all required documentation needs and time frames for compliance.
- Contact patients or their representatives to complete the appropriate applications and acquire all necessary releases, signatures, and documents.
- Maintain confidentiality regarding patient's health records.
- Submit applications and any acquired documentation in a timely manner to the appropriate agency.
- Thoroughly enter all actions taken in the client's account and in the internal data base/system.
Follow-up & Monitoring
- Maintain structured and timely contact with the applicant and responsible government agency.
- Assist applicants with gathering any additional reports or records, meeting appointment dates and times .
- As per established protocols, inform the client in a timely manner of all approvals and denials of coverage.
- Thoroughly enter all actions taken in the client account and in the internal data base/system.
Requirements:
- High School Diploma or equivalent required
- Knowledge of NJ Medicaid, Charity Care, and resource assistance experience in a hospital environment
- A minimum of 2 years of relevant experience
- Must obtain and maintain required certifications/credentials
- Bilingual - Ability to speak and read Spanish required
- Excellent communication skills (oral and written)
- Must be detail oriented and possess superior organizational skills
- Must be able to work in a team environment
- Proficient in various computer applications. (*Word, *Excel, Etc.)
- Must be able to travel between local sites on occasion based on client and business needs
- Provides superior customer service and maintains a professional image
- Understands and adheres to client's needs, internal procedures, and goals
- Communicates effectively with multiple constituencies within the facility
- Establishes and maintains strong working relationships
- Must be reliable, self-directed, and self-motivated and able to work in a fast-paced hospital environment
- Adhere to both Wakefield and Client policies, procedures, best practices, and guidelines
- Adhere to any federal, state, local laws and regulations
Benefits:
- Major Medical Insurance
- Flexible Spending Account
- Dental Insurance
- Vision Insurance
- Life Insurance
- Long Term & Short Term disability 100% paid by employer after 1 year
- Voluntary Term Life
- 401(k) Savings Plan
- UNUM Supplemental Insurance
- Paid Holidays
- Paid Time Off
Job Posted by ApplicantPro
