Medical Eligibility Specialist

1 day ago

Richfield, Pennsylvania, United States Firstsource Full time

Job Summary

We are seeking a skilled Medical Eligibility Specialist to join our team at Firstsource Solutions USA, LLC. As a Medical Eligibility Specialist, you will be responsible for screening patients on-site at hospitals for eligibility assistance programs, providing information and reports to client contacts, and keeping them current on our progress.

About the Role

This is an excellent opportunity for individuals with medical coding, billing, or eligibility experience to take their skills to the next level and make a positive impact on patients' lives. You will work closely with hospital staff of all levels and departments to identify self-pay patients and assist them in navigating the eligibility process.

Key Responsibilities

  • Review hospital census or utilize established referral method to identify self-pay patients consistently throughout the day.
  • Screen patients referred to Firstsource for State, County, and/or Federal eligibility assistance programs.
  • Initiate application process bedside when possible.
  • Identify specific patient needs and assist with enrollment application to the appropriate agency for assistance.
  • Introduce patients to Firstsource services and inform them of regular contact regarding their progress.
  • Provide transition for backend Patient Advocate Specialist to develop a positive relationship with the patient.
  • Record all patient information on designated in-house screening sheet.
  • Document results of screening in onsite tracking tool and hospital computer system.
  • Identify out-patient/ER accounts from census or applicable referral method that are designated as self-pay.
  • Review system for available information for each outpatient account identified as self-pay.
  • Face-to-face screen patients on site as able; attempt to reach patient by telephone if unable to screen face-to-face.
  • Document out-patient/ER accounts when accepted in hospital system and onsite tracking tool.
  • Outside field work as required, including patient home visits to screen for eligibility of State, County, and Federal programs.
  • Other duties assigned or required by client contract.

Additional Requirements

  • Maintain a positive working relationship with hospital staff of all levels and departments.
  • Report important occurrences to management promptly.
  • Access information for Patient Advocate Specialist as needed.
  • Keep accurate log of accounts referred each day.
  • Meet specified goals and objectives as assigned by management.
  • Maintain confidentiality of account information.
  • Maintain neat and orderly workstation.
  • Adhere to prescribed policies and procedures.
  • Maintain awareness of Corporate Compliance Program.

Education and Experience

  • High School Diploma or equivalent required.
  • 1-3 years' experience in medical coding, billing, eligibility, or other pertinent medical experience preferred.
  • Previous customer service experience preferred.
  • Basic computer skills required.

Working Conditions

  • Must be able to walk, sit, and stand for extended periods.
  • Dress code and other policies may vary at each healthcare facility.
  • Working on holidays or odd hours may be required.

Benefits

  • Estimated salary range: $35,000 - $45,000 per year.
  • Medical, Vision, Dental, 401K, Paid Time Off benefits.

Equal Opportunity Employer

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