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Bilingual Patient Eligibility Specialist

2 months ago

Elizabeth, New Jersey, United States Wakefield & Associates Inc Full time
**Facilities are located in Plainfield and Elizabeth**

The Bilingual Eligibility Services Representative plays a crucial role in conducting financial assessments to determine patient or guarantor eligibility for various federal, state, county, and local assistance programs, including but not limited to charity care and Medicaid. This individual will actively engage in the qualification process for all patients and guarantors, serving as a vital partner to our clients.

Key Responsibilities:

Application Process & Eligibility Assessments:
  • Evaluate referrals and assess patients/guarantors for potential eligibility in relevant assistance programs.
  • Inform applicants about necessary documentation and compliance timelines.
  • Reach out to patients or their representatives to finalize applications and obtain required releases, signatures, and documents.
  • Ensure confidentiality regarding patient health records is maintained.
  • Timely submission of applications and supporting documentation to the appropriate agencies.
  • Accurately document all actions taken in the client’s account and internal database/system.
Follow-up & Monitoring:
  • Maintain structured and timely communication with applicants and relevant government agencies.
  • Assist applicants in gathering additional reports or records and meeting scheduled appointments.
  • Notify clients promptly of all coverage approvals and denials as per established protocols.
  • Document all actions taken in the client account and internal database/system comprehensively.
Qualifications:
  • High School Diploma or equivalent is required.
  • Familiarity with NJ Medicaid, Charity Care, and resource assistance in a healthcare setting.
  • A minimum of 2 years of relevant experience is necessary.
  • Must obtain and maintain required certifications/credentials.
  • Bilingual - Proficiency in Spanish (both spoken and written) is required.
  • Exceptional communication skills (both oral and written).
  • Detail-oriented with excellent organizational skills.
  • Able to work collaboratively in a team environment.
  • Proficient in various computer applications (e.g., Word, Excel).
  • Willingness to travel between local sites as needed based on client and business requirements.
  • Demonstrates superior customer service and maintains a professional demeanor.
  • Understands and adheres to client needs, internal procedures, and organizational goals.
  • Effectively communicates with multiple stakeholders within the facility.
  • Establishes and nurtures strong working relationships.
  • Must be reliable, self-motivated, and capable of thriving in a fast-paced healthcare environment.
  • Adheres to all policies, procedures, best practices, and guidelines of Wakefield & Associates Inc.
  • Complies with all applicable federal, state, and local laws and regulations.
Benefits:
  • Major Medical Insurance.
  • Flexible Spending Account.
  • Dental Insurance.
  • Vision Insurance.
  • Life Insurance.
  • Long Term & Short Term Disability fully covered by the employer after one year.
  • Voluntary Term Life Insurance.
  • 401(k) Savings Plan.
  • UNUM Supplemental Insurance.
  • Paid Holidays.
  • Paid Time Off.