Medicaid Eligibility Specialist

It's inspiring to work with a company where people truly BELIEVE in what they're doing!

When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success!

Role:

The Medicaid Eligibility Specialist performs verification of benefits and obtains authorizations in accordance with all state, federal and third party payor contractual requirements.

Qualifications:

• High School Diploma or GED

• Minimum of one (1) year of medical billing and collection or office experience

• Knowledge of third party billing and state and federal collection regulations preferred

• Ability to prioritize and multi-task independently with little guidance

• Must be self-motivated and service oriented

• Excellent written and verbal communication skills

• Accurate typing and data entry skills

Competencies:

• Satisfactorily complete competency requirements for this position.

Responsibilities of all employees:

• Represent the Company professionally at all times through care delivered and/or services provided to all clients.

• Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse.

• Comply with Company policies, procedures and standard practices.

• Observe the Company's health, safety and security practices.

• Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company.

• Use resources in a fiscally responsible manner.

• Promote the Company through participation in community and professional organizations.

• Participate proactively in improving performance at the organizational, departmental and individual levels.

• Improve own professional knowledge and skill level.

• Advanced electronic media skills.

• Support Company research and educational activities.

• Share expertise with co-workers both formally and informally.

• Participate in Quality Assessment and Performance Improvement activities as appropriate for the position.

Job Responsibilities:

• Scans admissions for patients without insurance and files Medicaid applications

• Coordinates with families, social workers, patients, etc.

• Performs insurance benefit verification for all payors.

• Obtains authorization as required by plan benefit.

• Processes incoming correspondence from payors.

• Resolves any issues with coverage and escalates complicated issues to the Supervisor.

• Ensures timely, complete and accurate processing of benefit information.

• Prepares monthly nursing home room and board invoices.

• Collaborates with Medicaid Eligibility Vendor to obtain Medicaid eligibility.

• Obtains patient responsibility payment as needed.

• Performs other duties as assigned.

This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.