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Medicaid Eligibility Specialist
4 months 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:- 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.
