Inpatient Eligibility Specialist

3 weeks ago

Springfield, United States Mercy Full time
We're a Little Different

Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.

At Mercy, we believe in careers that match the unique gifts of unique individuals - careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its "Top 100 Places to Work."

*This is an Office - Based Position*

Overview:

Interviews uninsured/under-insured patients in a hospital setting to determine eligibility for State Medicaid benefits and Financial Assistance. Requires assisting patients in hospital rooms with the application processes to facilitate accurate and appropriate application submission. Requires building a positive relationship with the patient and communication of the eligibility process and the benefits of having Medicaid coverage. Oversight of signatures on State forms and clear communication regarding the additional documents the patient will need to provide to complete the application is central to this role. This position is in the facility and is not remote.

Inpatient Eligibility Specialists job duties include but are not limited to reviewing all referred uninsured/under-insured patients for a variety of program eligibility opportunities in ED and inpatient rooms. Initiates and coordinates the application process to facilitate accurate and appropriate submissions. Effectively communicating with the patient to obtain documents that must accompany the application.

This role is fast paced, and the screener must work quickly, effectively, efficiently, and accurately to meet with all patients prior to discharge.

Qualifications:
  • Experience: 1-2 years of experience in the healthcare industry, social work, or case management environment, interacting with patients regarding financial concerns, working with self-pay, underinsured, or a compromised population in a face-to-face customer service capacity proactively explaining complicated programs.
  • Education: High School Diploma or GED
  • Other: Understanding of Revenue Cycle functions including billing, payments, denials, authorizations, and benefit verifications. Knowledge of health insurance requirements. Knowledge of medical terminology. Patient access experience with managed care/insurance knowledge. Ability to comprehend various state Medicaid plan qualifications and communicate patient benefits clearly and effectively to those most likely to benefit. Good math skills and ability to identify best program for an applicant out of those available. Complete written applications with patients to submit to state agencies and ensure the supporting documents will be provided timely. Customer service ability, strong face to face communication skills, background working with customers or patients on document completion and applications, knowledge of medical expenses and associated bills, knowledge of patient insurance, ability to multitask, ability to learn complex state requirements for programs and explain to patients, bias for action, patient/consumer focused, entrepreneurial and commitment to excellence and service.


We Offer Great Benefits:

Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period

We're bringing to life a healing ministry through compassionate care.

At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We're expanding to help our communities grow. Join us and be a part of it all.

What Makes You a Good Match for Mercy?

Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We're also collaborative and unafraid to do a little extra to deliver excellent care - that's just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.

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