On-Site Eligibility Specialist in Indianapolis, Indiana at CareEnroll LLC

POSITION OVERVIEW

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.

RESPONSIBILITIES

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

• 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.
• 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
• Accuracy of screenings will be tracked, measured and reviewed
• Initiates appropriate applications for Medicaid/HIP patients and completes timely follow-up until account is resolved.
• 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.
• Initiates and/or assists patients in obtaining pertinent medical and financial documentation for case processing.
• Develops and maintains excellent client/patient/ Enroll Plus staff relationships exhibiting care, courtesy and respect.
• Maintain a Quality Assurance score of 95%
• Monitor accounts by maintaining regular follow up with FSSA to determine status of case processing.
• Inventory Management will be tracked, measured and reviewed
• Attend all required meetings and conferences.
• Always adheres to the organization’s confidentiality policy and the protection of confidential information including all company policies and procedures and the EnrollPlus Extended Policy.
• Other duties, responsibilities and activities may change or be assigned at any time with or without notice.
• Attain individual department goals: Screening 90%, Application 95% and Approval 85%.

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.

COMPETENCIES

• Great attention to detail and accuracy.
• Proficiency in basic computer skills.
• Working knowledge of Excel and Microsoft products.
• Analytical skills necessary to screen patients appropriately for various Governmental Programs Working knowledge of Excel and Microsoft products.
• Strong Organizational, Planning and Time management skills and the ability to self-prioritize work.
• Ability to relate to hospital personnel, manage in a highly political environment relate to indigent patients.
• Agility – the ability to adapt to changes in the market and client demands.
• Excellent interpersonal and communication skills (both verbal and written) necessary to interact with staff, patients and clients including having pleasant disposition and possessing the ability to maintain a cordial and professional demeanor even during periods of stress
• Exhibit the core values of the organization; Help First, Victor not Victim, Grow or Die, Make a Difference, Straight talk
• Adherence to the organization’s core values will be tracked, measured and reviewed

WORK ENVIRONMENT

The role operates in a professional remote environment and uses standard office equipment, such as computers and phones.

PHYSICAL DEMANDS

While performing the duties of this job, the employee is regularly required to talk or hear. Frequent requirements include sitting, using hands to finger, handle, or feel, and reaching with hands and arms. The job involves prolonged periods sitting at a desk and working on a computer and occasionally lifting to 15 pounds.

POSITION TYPE AND EXPECTED WORK HOURS

Full-time, Monday–Friday, with flexibility for evenings and weekends as needed.

TRAVEL

Moderate travel is required for client meetings, industry events, and site visits.

EDUCATION AND EXPERIENCE

Required

• High School Diploma or GED
• Licensed Indiana Navigator within 90 days of starting in the position.
• Working familiarity with various hospital patient accounting systems and/or self-pay processes.
• One year’s experience with general clerical/administrative duties.

PREFERRED

• Associate or bachelor’s degree in business or related field.
• Previous experience in determining eligibility and completing follow up for Government Programs and the ability to relate to patients and co-workers
• Knowledge of pertinent Medicaid/HIP programs highly preferred.

Additional Eligibility Qualifications

• Flu Vaccination (confirmation that the vaccination was administered)
• Flu vaccination Only required if start date October- May. If not vaccinated, mask must be worn in facility.
• Covid vaccination- No longer required as of June 5,2023.
• TB Test (negative)
• MMR Vaccination/Titer Records (either proof of immunity or proof the vaccination was administered)
• Varicella Vaccinations (confirmation that the employee has proof of immunity, or the vaccination was administered)