Eligibility Advocate
- Our medical, dental, vision, and life insurance benefits are available from the first day of employment
- Our Employee Resource Groups build community and foster a culture of belonging and inclusion
- We match 401(k) contributions
- We offer career growth opportunities
- We celebrate 12 paid holidays and generous paid time off
- Follows established Company protocol and procedures on case load management for active and approved.
- Documents Company database with action that was taken on the account/application in a timely manner. Effectively and accurately follows established work procedures and guidelines to be efficient in the Medicaid application processes. Includes application completion, collection of all documentation, including detailed case comments.
- Maintains a current caseload according to Company protocol.
- Attends any company and/or facility compliance training.
- Complies with all company policies as well as state and federal regulations including, but not limited to attendance, performance, patient privacy, system security and safety.
- Maintains knowledge of all State Medicaid and CHP+ policy information/guidelines/training.
- Locates, understands, and interprets written information in a variety of formats including such documents such as manuals, reports, graphs, etc.
- Uses own vehicle to travel to various locations for reasons including, but not limited to, outside training, facility coverage, home visits, and agency visits.
- Uses reference material available on Company resource sites, state/county websites, and other web-based sites effectively and regularly.
- Effectively uses computer systems to include but not limited to Company database system, and hospital system.
- Effectively documents and demonstrates a performance standard of 85 consistently.
- Assist with the entry of all referrals and account documentation.
- Contact and screen patients for eligibility. Screenings are completed in the hospital, by phone, and occasionally in patient's home.
- Complete and copy all relevant applications.
- Gather all required verification documents and submit them to appropriate agencies by the deadline for processing.
- Follow up with agencies to ensure submitted applications are processed in a timely manner.
- Assist in appealing denied applications.
- Update all hospital and company systems with current activity and notes.
- Submit verified billing numbers to facilities.
- Provide hospital with all requested information in a timely manner.
- Complete assigned invoicing functions including capturing claim bill dates, payment dates and payment amounts, from hospital system and assigning appropriate invoice fee types.
- Comply with all state and federal regulations and company policies that include but not limited to patient privacy (HIPAA).
- Perform various other duties, as assigned.
- Comply with the company's code of conduct.
- Additional duties and responsibilities as assigned.
- High school diploma or general education degree (GED);
- One to three years of related experience such as advocacy and customer service and/or training; or equivalent combination of education and experience.
- Case management experience and working knowledge of State and Federal programs such as Medicaid and Social Security Disability, is a plus,
- Experience with hospital billing systems (Meditech, EPIC, Allscripts, MS4, etc.) desired.
- Past advocacy experience or experience with helping others through enrollment processes is a positive.
- Must be comfortable working directly with patients in an inpatient hospital room environment, to include behavioral health patients.
- Ability to quickly and accurately capture heavy documentation requirements in both the company and hospital computer systems
- MS Office proficiency
- Strong typing and documentation skills
- Exemplary customer service
- Strong written and verbal communication skills
- Strong time management and organizational skills
- Bilingual English / Spanish is required for some positions
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