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Medicaid Eligibility Specialist
4 weeks ago
It's inspiring to work with a company where people truly BELIEVE in what they're doing
When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success
Role:
The Medicaid Eligibility Specialist performs verification of benefits and obtains authorizations in accordance with all state, federal and third party payor contractual requirements.
Qualifications:
* High School Diploma or GED
* Minimum of one (1) year of medical billing and collection or office experience
* Knowledge of third party billing and state and federal collection regulations preferred
* Ability to prioritize and multi-task independently with little guidance
* Must be self-motivated and service oriented
* Excellent written and verbal communication skills
* Accurate typing and data entry skills
Competencies:
* Satisfactorily complete competency requirements for this position.
Responsibilities of all employees:
* Represent the Company professionally at all times through care delivered and/or services provided to all clients.
* Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse.
* Comply with Company policies, procedures and standard practices.
* Observe the Company's health, safety and security practices.
* Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company.
* Use resources in a fiscally responsible manner.
* Promote the Company through participation in community and professional organizations.
* Participate proactively in improving performance at the organizational, departmental and individual levels.
* Improve own professional knowledge and skill level.
* Advanced electronic media skills.
* Support Company research and educational activities.
* Share expertise with co-workers both formally and informally.
* Participate in Quality Assessment and Performance Improvement activities as appropriate for the position.
Job Responsibilities:
* Scans admissions for patients without insurance and files Medicaid applications
* Coordinates with families, social workers, patients, etc.
* Performs insurance benefit verification for all payors.
* Obtains authorization as required by plan benefit.
* Processes incoming correspondence from payors.
* Resolves any issues with coverage and escalates complicated issues to the Supervisor.
* Ensures timely, complete and accurate processing of benefit information.
* Prepares monthly nursing home room and board invoices.
* Collaborates with Medicaid Eligibility Vendor to obtain Medicaid eligibility.
* Obtains patient responsibility payment as needed.
* Performs other duties as assigned.
This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.
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