Here at Wellpath, everything that we do is about taking care of people - our patients, our staff and our partners. We are committed to making a difference by providing hope and healing to vulnerable patients in challenging clinical environments. Our talented, compassionate team thrives in an autonomous environment, is empowered and supported by education, training and the resources to practice healthcare the way it is meant to be and strives to "Always Do The Right Thing!"
Our Benefits Entitlement Coordinator will perform insurance eligibility and enrollment activities for patients with inpatient stays.
Perform weekly EEDR reviews to identify inpatient Stays and verify NFL edits are in place. Review Care Management IP Stay reports to identify eligible inpatient stays.
Assist hospitals, site staff, and persons-served with enrollment applications and when applicable submit enrollment applications for inpatient stays. Complete Medicare/Medicaid enrollment activities within the state specified time limits. Notify providers of the patient's insurance identification number for billing purposes.
Maintain the control file to reflect enrollment application progress and status. Work with claims to identity possible improper payments, in instances where insurance should have been billed. Initiate Medical Reviews when the provider notifies us an inpatient designation should be observation.
Must be able to apply principles of critical thinking to a variety of practical and emergent situations and accurately follow standardized procedures that may call for deviations. Must be able to apply sound judgment beyond a specific set of instructions and apply knowledge to different factual situations. Must be alert at all times; pay close attention to details.
Must be able to work under stress on a regular or continuous basis. Meet with persons-served to review accuracy and completion of signature for insurance applications. Maintain database for indigent persons-served.
Ensure all eligible persons-served Medicaid application are submitted. Responsible for monthly insurance reporting requirement to the client. Perform other duties as assigned.
Wellpath is an EOE/Minorities/Females/Vet/Disability Employer
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