Medicaid Eligibility Benefits Advisor

Position Summary:
Responsible for conducting eligibility screenings, assessment of patient financial requirements, and counseling patients on insurance benefits and co-payments. The Benefits Advisor serves as a liaison between the patient, hospital, and governmental agencies; and is actively involved in all areas of case management.

Must be available to work flexible hours.

Essential Job Functions:
1. Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, or hospital charity application.
2. Re-verifies benefits and obtains authorization and/or referral after treatment plan has been discussed, prior to initiation of treatment. Ensures appropriate signatures are obtained on all necessary forms.
3. Obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination.
4. Complete and file applications. Initiate and maintain proper follow-up with the patient and government agency caseworkers to ensure timely processing and completion of all mandated applications and accompanying documentation.
5. Ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately. Document progress notes to the patients file and the hospital computer system.
6. Participates in ongoing, comprehensive training programs as required.
7. Follows policies and procedures to contribute to the efficiency of the office. Covers and assists with other office functions as requested.

Disclaimer: The above statements are intended to describe the general nature and level of work being performed. They are not intended to be an exhaustive list of responsibilities, duties and skills required.