Eligibility Specialist

3 months ago

Camden, United States Savista Full time

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

  • The Bilingual Eligibility Specialist 1 works in one of our Savista service centers, Client Sites, Remote or Outreach (Fieldwork) locations to help identify financial assistance programs for the uninsured or underinsured customers (Remote/Onsite). They assist with the application process and referrals to all State and Federally funded assistance programs, including but not limited to Medicare, Medicaid, Disability, Charity and FAP (Financial Assistance) programs. The Eligibility Specialist not only acts as an advocate for the customer, but also serves as a liaison between colleagues, clients, and State/Government agencies in a collaborative effort to facilitate eligibility coverage for current and future medical expenses.
    Responsibilities:
    •Handle high volume of inbound/outbound calls for customers that need to be screened financially and medically for financial assistance.
    •Perform face to face interviews and/or phone interviews with customers at client site or home environment to determine eligibility for financial assistance. (Onsite)
    •Provide superior customer service to multiple clients and/or working with multiple client platforms.
    •Use Savista's eligibility screening to determine customers eligibility for all State and Federally funded programs that will provide financial assistance to resolve current or future hospital bills.
    •Conduct the appropriate application support based upon state or federal regulations. Facilitates the application process or directs the customer to the appropriate next step.
    •Perform specialty follow up for multiple eligibility programs.
    •Collect and process upfront deposits or set up payment arrangements, as required.
    •Provide instruction or work directly with the customer or their appointment of a representative to complete the appropriate application and acquire all necessary releases, signatures and supporting documents.
    •Submit the application and supporting documentation to the appropriate institution in accordance with company protocol.
    •Act as an advocate for the customer, but also serves as a liaison to other colleagues, client hospital personnel, and government agency staff in a collaborative effort to establish eligibility coverage for future or incurred medical expenses.
    •Maintain AIDET guidelines (acknowledge the patient, introduce yourself, explain the duration or timeline of your process, explain to them what you are doing, thank the patient for their time).
    •Meet or exceed established productivity with the support of the supervisor, QA team, educational materials and webinars, and partner with their colleagues, achieve accuracy rate of 95%. Maintaining Financial Assistance or Charity Care application processing error ratio of less than 5%.
    •May travel up to 10% to government agencies, patient homes, or other facilities/hospitals. (Per contract as needed)
    •Provide superior healthcare customer service and maintain a professional image.
    •Maintain acceptable attendance, appointments, and schedule requirements
    •Supports Savista's Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to Savista's business practices. This includes becoming familiar with Savista's Code of Ethics, attending training as required, notifying management or Savista's Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.
    Requirements:
    •Bilingual in English and Spanish (or any other languages).
    •Works 1 weekend a month.
    •Work 8:30am to 5pm
    •Provide coverage when needed to any of the locations: (Primary coverage Site will be assigned)
    o Camden
    •High school diploma or GED.
    •2+ years of experience in a customer service role, interacting directly with customers either in-person or over the phone.
    •Intermediate knowledge of patient access services and the overall effect on the revenue cycle.
    •Demonstrated experience communicating effectively with a customer and simplifying complex information.
    •Demonstrated ability to handle escalated customer and client issues.
    •Proven capability to think critically and drive successful solutions for client and/or patient concerns.
    •Experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievements of performance metrics.
    •Experience in a role that requires accessing multiple databases simultaneously or managing multiple open screens to gather information to discuss with a customer.
    •Experience with customer interactions that require live, accurate documentation of the encounter.
    •Ability to handle sensitive information and maintain HIPAA compliance.
    •Demonstrated ability to navigate Internet Explorer and Microsoft Office.
    •Maintain acceptable attendance and schedule requirements.
    •Must be able to drive a personal automobile (Required for Field Positions only).
    •Amount of travel required: moderate (Field Positions only).

    Preferred Skills:
    •A thorough understanding of commercial and government insurance plans, payer networks, government resources, and medical terminology.
    •2 years of experience working within financial counseling in a Hospital, Physician office or home environment, including demonstrated success in obtaining patient demographic and financial information, handling insurance verification and obtaining authorizations.
    •Thorough understanding of federal or state government agencies including Social Security, Medicaid or Charity Care, or healthcare accounts receivable within the healthcare revenue cycle touching patient accounts.
    •2+ years of experience working in a role with a high volume of either inbound or outbound calls through an automatic dialer.


Preferred Skills:

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

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