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    Medicaid Eligibility Specialist - Temple Terrace, United States - Chapters Health System

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    Description
    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.



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