Bilingual Eligibility Services Representative

4 weeks ago

Elizabeth, United States Wakefield & Associates Inc Full time
**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

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