Job Summary We are seeking a dedicated and detail-oriented Eligibility Specialist to join our healthcare support team for our Hospital census. In this vital 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. This position offers an exciting opportunity to make a meaningful impact on individuals' access to essential healthcare services while working in a dynamic, team-oriented environment. Duties Review patient applications and verify eligibility for Medicaid, Medicare, and other health insurance programs in accordance with current regulations. Conduct thorough assessments of medical records, demographic data, and supporting documentation to determine program qualification. Collaborate with healthcare providers, social workers, and case managers to gather necessary information for eligibility determinations. Communicate effectively with clients via phone or in person to explain eligibility requirements, answer questions, and provide guidance on next steps. Assist with discharge planning and case management activities Support data entry tasks related to client information, ensuring accuracy and completeness in healthcare support systems. Participate in ongoing training related to healthcare support practices, medical terminology, and behavioral health issues. Requirements Prior experience working in hospital settings or acute care environments is highly preferred. Knowledge of medical coding systems such as ICD (International Classification of Diseases) codes—ICD-9 and ICD-10—and CPT coding is essential. Strong understanding of Medicaid regulations, health insurance policies, and patient service protocols. Experience working with electronic health records (EHR) or electronic medical records (EMR) management systems. Excellent communication skills; bilingual abilities are a plus for serving diverse populations. Background in social work or case management with familiarity in behavioral health and pediatrics is advantageous. Ability to handle sensitive information discreetly while maintaining patient confidentiality per HIPAA standards. Strong organizational skills with attention to detail for data entry and record keeping tasks. Compassionate approach when working with individuals experiencing mental health challenges or from underserved communities. Experience working with individuals who have co-occurring disorders or complex healthcare needs is highly valued. Join us in delivering compassionate healthcare support by ensuring clients receive the benefits they deserve! This paid position offers a rewarding career path dedicated to improving access to vital health services through meticulous eligibility assessment and client communication.

Pay:

$10.00 - $15.00 per hour

Work Location:

In person