Eligibility Representative

5 days ago

Cedar Park, Texas, United States Cedar Park Regional Medical Center Full time
Job Summary

Cedar Park Regional Medical Center is seeking a highly skilled Eligibility Representative to join our team. As an Eligibility Representative, you will play a critical role in ensuring that our patients receive the financial assistance they need to access essential benefits.

Key Responsibilities
  • Engage with Patients: Meet with self-pay patients to evaluate their eligibility for programs like Medicaid, Medicare, and other assistance options.
  • Uncover Payment Sources: Investigate and identify all possible payment sources, including auto insurance, Workers' Compensation, commercial insurance, private insurance, and Third Party Liability (TPL).
  • Streamline Account Routing: Accurately route patient accounts within our Patient Accounting environment based on identified payor sources, ensuring smooth and efficient processing.
  • Financial Documentation: Assist patients in completing the Confidential Financial Statement form, capturing all necessary information.
  • Benefit Application Assistance: Support patients through the application process for various benefits, offering guidance and essential information to help them access available resources.
  • Detailed Documentation: Maintain comprehensive and accurate records of all patient interactions, eligibility screenings, and application processes in our systems.
  • Continuous Learning: Stay up-to-date on changes in eligibility criteria, program requirements, and best practices in patient advocacy and support.
  • Adherence to Compliance: Uphold all relevant laws, regulations, and hospital policies, ensuring patient confidentiality and privacy at all times.
  • Collaborative Efforts: Partner with other hospital departments, such as Patient Access, Case Management, Social Services, Billing, and Patient Advocacy, to provide comprehensive support for our patients.
Qualifications
  • Education: High school diploma or equivalent required; Associate's or Bachelor's degree in a related field preferred.
  • Experience: Previous experience in a healthcare setting, preferably in patient financial services or a related field.
  • Knowledge: Familiarity with State, Federal, or other assistance programs, insurance verification, and patient accounting processes preferred.
  • Skills: Exceptional communication and interpersonal skills; strong analytical and problem-solving abilities; proficiency in using computer systems and software for documentation and eligibility screening; ability to work independently and manage multiple tasks effectively; compassionate and patient-focused approach to service delivery.
  • License and Certification: Certification Application Counselor (CAC) through the Affordable Care Act (ACA); Insurance Navigator license required for residents of GA and IN.
Working Conditions
  • Environment: Hospital setting, including Patient Rooms/Emergency Department and Administrative Offices.
  • Physical Requirements: The Employee may be required to occasionally lift a minimum of 25 pounds, climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions; the Employee is required to read, review, prepare and analyze written data and figures, using a computer or similar.

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