Insurance Enrollment Specialist

Medicaid/HIP On-Site Eligibilty Specialist

Job Description

Reports to: EnrollPlus Manager

Company: CareEnroll

Department: EnrollPlus

Title: Medicaid/HIP On-Site Eligibilty

Specialist Classification: Non-Exempt

Position Summary:

Medicaid/HIP On-Site Eligibility Specialist is responsible for reviewing and evaluating all Self Pay accounts daily for potential payment sources, including Medicaid, HIP, HHW, Marketplace and third party liabilities. Successfully resolves all potential Medicaid/Government Assistance applications referred by Clients.

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Reviews all Self Pay and referral accounts for potential Medicaid/HIP eligibility, as well as Identifies third party liabilities, Victims of Violent Crimes, and potential charity.

2. Conducts face-to-face screenings with patient and/or patient's family while patient is in-house and performs phone follow-up on discharged patients o Face-to-face screenings are on a case-by-case basis due to COVID precautions

3. Initiates appropriate applications for Medicaid/HIP patients and completes timely follow-up until account is resolved.

4. Updates hospital computer system and legacy system as to current financial status of accounts that have been reviewed and maintain a weekly in-house log of all client referrals.

5. Initiates and/or assists patients in obtaining pertinent medical and financial documentation for case processing.

6. Develops and maintains excellent client/patient/ Enroll Plus staff relationships exhibiting care, courtesy and respect. o Maintain a Quality Assurance score of 95%

7. Monitor accounts by maintaining regular follow up with FSSA to determine status of case processing.

8. Attends all required meetings and conferences.

9. Adheres to the organization's confidentiality policy and the protection of confidential information at all times including all company policies and procedures and the EnrollPlus Extended Policy.

10. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.

11. Attain department goals set for Revenue, Applications and Approvals to maintain a 90% combined average.

Competencies

1. Great attention to detail and accuracy.

2. Proficiency in basic computer skills.

3. Working knowledge of Excel and Microsoft products.

4. Analytical skills necessary to screen patients appropriately for various Governmental Programs Working knowledge of Excel and Microsoft products.

5. Strong Organizational, Planning and Time management skills and the ability to self-prioritize work.

6. Ability to relate to hospital personnel, manage in a highly political environment relate to indigent patients.

7. Agility – the ability to adapt to changes in the market and client demands.

8. Excellent interpersonal and communication skills (both verbal and written) necessary to interact with staff, patients and clients including having a pleasant disposition and possessing the ability to maintain a cordial and professional demeanor even during periods of stress

9. Exhibit the core values of the organization; Help First, Victor not Victim, Grow or Die, Make a Difference, Straight talk

Supervisory Responsibility

This position has no supervisory responsibility.

Work Environment

This position is onsite in hospital facility, with the potential of a Hybrid model work schedule, based on client need. This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.

Position Type and Expected Hours of Work

This is a full-time position, and hours of work and days are Monday through Friday, 8:00 a.m. to 4:30 p.m. Evening and weekend work may be required as job duties demand.

Travel

Travel is primarily local during the business day, although some out-of-the-area and overnight travel may be expected.

Required Education and Experience

1. High School Dipolma or GED

2. Licensed Indiana Navigator within 90 days of starting in the position.

3. Working familiarity with various hospital patient accounting systems and/or self-pay processes.

4. One year experience with general clerical/administrative duties.

Preferred Education and Experience

1. Associates or Bachelor's degree in business or related field.

2. Previous experience in determining eligibility and completing follow up for Government Programs and the ability to relate to patients and co-workers

3. Knowledge of pertinent Medicaid/HIP programs highly preferred.

Additional Eligibility Qualifications as vendors to Franciscan Alliance

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Application Question(s):

• Have you worked in a remote and/or hybrid position before?
• This full-time position. Does that meet your requirement?
• How soon would you be available to start?
• Are you able to perform weekend work if required?
• Do you have experience working with Medicaid/Medicare?
• What are your hourly pay rate requirements for this position?
• What is the best email address to reach you at?
• Were you referred for this position?

Education:

• High school or equivalent (Required)

Ability to Commute:

• Lafayette, IN Required)

Work Location: Hybrid remote in Lafayette, IN 47905