Community Health Eligibility & Enrollment

POSITION SUMMARY:

This position provides Medicaid enrollment support and financial assistance services for community-based individuals.

KEY RESPONSIBILITIES:

• Screen and assist with all steps of the Medicaid and Charity Care enrollment process.
• Make follow-up phone calls and home visits or visits to other appropriate settings (e.g., community-based organizations) to explain the Medicaid enrollment process and to enroll individuals in appropriate services such as health insurance
• Ensure timely submission of Medicaid or Charity application based off program guidelines
• Gather, verify, evaluate, and enter necessary social, financial, and medical information into various applications
• Outreach to individuals to determine Medicaid eligibility and continuing eligibility for income maintenance programs related to medical services
• Utilizes tools to estimate patient financial obligations, including copays, deductibles, and coinsurance and then meeting with patients to discuss payment options.
• Work with hospital team staff to identify difficult-to-reach clients and provide strategies for reaching them
• Meets in-person with patients in Emergency Room, Inpatient Floors and Outpatient Clinics to explain patient financial responsibilities and collect/secure any out-of-pocket responsibility.
• Receives and maintains Certified Application, if applicable

• Meet or exceed daily standards for performance, accuracy, customer service, and quality

REQUIRED KNOWLEDGE & SKILLS:

• Excellent customer service skills.
• Excellent communication skills (verbal and written).
• Knowledge of health insurance and reimbursement/billing required.
• Attention to detail, and advanced writing and presentation skills for communicating across a variety of stakeholders.
• Revenue Operations experience, including Patient Access, Registration, Scheduling and Financial Clearance.
• Experience level will also be a factor in lieu of educational requirements
• Bilingual; Spanish-speaking preferred.

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

1. Education: High School Diploma or equivalent. Associates Degree preferred.
2. Experience (Type & Length): 3-5 years’ relevant work experience required.
3. Other: Bilingual; Spanish-speaking preferred.