Job Summary We are seeking a dedicated and detail-oriented Eligibility Specialist to join our healthcare support team. In this role, you will be responsible for assessing patient eligibility for various health programs, including Medicaid and other insurance plans, ensuring compliance with federal and state regulations. The ideal candidate will possess strong medical coding skills, experience with electronic health records, and a compassionate approach to working with diverse populations, including individuals with mental health conditions and co-occurring disorders. This position offers an opportunity to contribute meaningfully to patient access to essential healthcare services while maintaining the highest standards of confidentiality and accuracy. Responsibilities Review patient information and verify eligibility for Medicaid, Medicare, and other health insurance programs in accordance with current regulations. Utilize EMR/EHR systems to accurately document patient data, insurance details, and case notes. Apply CPT coding, ICD-9, and ICD-10 codes to medical records for billing and documentation purposes. Conduct intake assessments and assist with discharge planning for patients across various healthcare settings. Collaborate with social workers, case managers, and healthcare providers to facilitate seamless patient care coordination. Ensure compliance with HIPAA regulations by maintaining strict confidentiality of all patient information. Assist in the review and validation of medical records to support accurate billing and reimbursement processes. Provide excellent client communication by explaining eligibility criteria and answering questions professionally. Stay informed about updates in Medicaid regulations, healthcare policies, and medical coding standards. Support data entry tasks related to patient eligibility and insurance claims processing. Requirements Prior experience working in hospital or acute care settings is highly preferred. Strong knowledge of medical terminology, CPT coding, ICD-9, ICD-10 coding systems, and medical records management. Experience working with electronic health records (EHR) systems such as Epic or Cerner. Familiarity with Medicaid regulations, healthcare support services, and discharge planning procedures. Background in social work or behavioral health is advantageous. Excellent organizational skills with attention to detail in data entry and documentation. Ability to communicate effectively across diverse populations; bilingual skills are a plus. Knowledge of HIPAA compliance standards and maintaining patient confidentiality. Experience working with individuals from underserved communities or those with co-occurring mental health disorders. Strong customer service orientation combined with case management capabilities. Ability to adapt quickly to changing healthcare policies and procedures. If you are passionate about ensuring equitable access to healthcare through meticulous eligibility assessment and compassionate client interaction, we encourage you to apply today. Join our team dedicated to making a positive impact on community health outcomes through professional excellence.

Pay:

$26.00 per hour Expected hours: 40.0 per week

Benefits:

Dental insurance Health insurance Paid time off Vision insurance

Work Location:

In person