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Team Lead Medicaid Eligibility Advocate in St Helena at Parallon

Date Posted: 12/5/2018

Job Snapshot

Job Description

Do you have a passion for healthcare and helping others? Do you enjoy working in a fast-paced, patient-centered environment? Jump-start your career in our Government Programs department and apply today to be a Patient Benefit Advisor.
Parallon's Mission:
We serve and enable those who care for and improve human life in their communities.
Parallon, a division of HCA, is an industry-leading provider of patient financial and revenue cycle services to acute care providers across the United States. We are dedicated to our values and passionate about finding future leaders for our fast-growing divisions. Although we are the largest healthcare provider in the world and experts and leaders in revenue cycle services, we maintain a people-first culture and sense of community. 


GENERAL SUMMARY OF DUTIES –Provides leadership to designated areas of responsibility, including direction of on-site staff.  Responsible for affecting ongoing quality, productivity, and efficiency by actively working with operations of designated facility.

 


DUTIES INCLUDE BUT ARE NOT LIMITED TO:

•        Monitor and oversee all daily operational duties and ensure that all employees adhere to all operational policies and procedures.
•        Maintain staff work schedules on a weekly or monthly basis.
•        Ensure work flow is consistent and timely for each employee.
•        Enforce disciplinary action as warranted concerning any employee misconduct.
•        Act as primary liaison to hospital staff/management.
•        Respond to daily questions and concerns raised by hospital staff/management in a timely and responsible manner.
•        Reviews all referred uninsured patients for potential state and federal assistance programs.
•        Assists with application process to facilitate possible assistance approval and timely billing.
•        Visits with patient in hospital or outside location (i.e., residence, employer, etc.) to finalize documents vital to assistance approval.
•        Reviews all inpatient admissions to identify and ensure accurate record of all Medicaid primary and secondary eligible days. If application denied, assists patients with appeals process as needed.
•        Reviews daily all certified and denied accounts to ensure the correct IPlan is appended and requests a rebill for a smooth handoff for Medicaid Authorizations.
•        Serves as a backup for Financial Counselor position, reviewing in-house patients to ensure insurance coverage information and/or financial situation documented in Meditech is accurate.
•        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

•       Working knowledge of medical terminology, practices and procedures, as well as laws, regulations, and guidelines.
•       Organization - proactively prioritizes needs and effectively manages resources
•       Communication - communicates clearly and concisely, verbally and in writing
•       Customer Orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
•       Leadership - guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
•       Tactical execution - oversees the development, deployment and direction of complex programs and processes
•       PC Skills - demonstrates proficiency in PC applications as required
•       Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
•       Basic Skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
•       Technical skills including:
•        Knowledge of state and federal assistance program requirements preferred.
•        Experience interacting with local Social Services personnel or departments.
•        Knowledge of medical terminology and computer literate.
•       Bilingual/Spanish preferred (may be required depending on facility).
•       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.
 


EDUCATION

•     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.


 



CERTIFICATE/LICENSE

Certified Application Counselor (Affordable Care assistance) -Preferred


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.

 

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