Medicaid Verification Specialist

1 month ago


San Antonio, United States Baptist Neighborhood Hospital Full time

The Eligibility Specialist is responsible for assisting hospital patients with the completion of the application process for Medicaid. The Eligibility Specialist not only acts as an advocate for the patient, but also serves as a liaison to other Team members and to client hospital in a collaborative effort to facilitate eligibility coverage for incurred medical expenses.



Basic Qualifications

  • High School Diploma or GED, required.
  • 1 plus years of experience with Federal and State financial assistance programs and third party coverage.
  • Knowledge of Microsoft Office Tools (Microsoft Word, Excel and Outlook), required.
  • Position requires fluency in English and Spanish; written and oral communication, required.


Essential Job Functions

  • Interviews clients or authorized representative to gather information while determining eligibility for benefits.
  • Obtains, verifies, and calculates income and resources to determine client's financial eligibility.
  • Assists patients in completion of program applications and other paperwork.
  • Accurately inputs and updates data and/or coverages in the eligibility determination system and the hospital computer system when changes occur and cross trains in all areas of eligibility.
  • Verifies, updates, and enter third party insurance plans into Eligibility and Hospital computer system.
  • Obtains and scans all necessary demographic and financial information required to properly determine potential program eligibility.
  • Maintains a minimal error rate and maintains productivity levels as determined by established standards and guidelines.
  • Provides superior customer service and maintains a professional image.


Other Job Functions

  • Attend staff meetings or other company sponsored or mandated meetings as required.
  • Perform additional duties as assigned.


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