Medicaid Eligibility Advisor - Conroe Regional in Conroe at Parallon

Date Posted: 10/4/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Conroe
  • Job Type:
  • Experience:
    At least 3 year(s)
  • Date Posted:
    10/4/2018

Job Description


Medicaid Eligibility Advisor
 
Parallon believes that organizations that continuously learn and improve will thrive. That’s why after more than a decade Parallon remains dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry’s leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services.
 
We offer you an excellent total compensation package, including competitive salary, excellent benefit package and growth opportunities. We believe deeply in our team and your ability to do excellent work with us. Your benefits package allows you to select the options that best meet the needs of you and your family. Benefits include 401k, paid time off medical, dental, flex spending, life, disability, tuition reimbursement, employee discount program, employee stock purchase program and student loan repayment. We would love to talk to you about this fantastic opportunity.
 
GENERAL SUMMARY OF DUTIES 
You will be responsible for conducting eligibility screenings, assessment of patient financial requirements, and counseling patients on insurance benefits and co-payments.  As a Medicaid Eligibility Advisor, you will serves as a liaison between the patient, hospital, and governmental agencies; and you will be actively involved in all areas of case management.
 
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
  • Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, or hospital charity application.
  • Re-verify 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.
  • Ensures appropriate signatures are obtained on all necessary forms
  • Obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination.
  • 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.
  • Ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately. 
  • Document progress notes to the patient's file and the hospital computer system.
  • Participates in ongoing, comprehensive training programs as required.
  • Follows policies and procedures to contribute to the efficiency of the office.
  • Covers and assists with other office functions as requested.
  • Will be required to make field visits as necessary.
  • Adheres to and supports organizational IT&S standards, policies, and procedures.
  • Adheres to Code of Conduct.
  • Performs other duties as assigned.

Job Requirements

KNOWLEDGE, SKILLS & ABILITIES
EDUCATION

  • Working knowledge of medical terminology, practices and procedures, as well as laws, regulations, and guidelines. 
  • An understanding of patient confidentiality to protect the patient and the clinic/corporation. 
  • Demonstrated communication, problem solving and case management skills and the ability to act/decide accordingly.  
  • Ability to collect, synthesize and research complex or diverse information.
  • Exceptional customer service and the ability to plan organize and exercise sound judgment.
  • College degree preferred or high school diploma (equivalent).

EXPERIENCE: 

  • A minimum three years of hospital/medical business office experience with insurance procedures and patient interaction. 
  • Strong familiarity with a variety of the field's concepts, practices and procedures. College degree preferred or high school diploma (equivalent).

PHYSICAL DEMANDS/WORKING CONDITIONS : 

  • Requires prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports. Requires lifting papers or boxes up to 50 pounds occasionally.  Work is performed in an office environment. Work may be stressful at times. Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations. Occasional travel to division data center and/or other facilities may be required.