Eligibility Advocate

Revecore; Valdosta (GA); On-site; USD 42,000 - 54,000; Full time

Job summary

Revecore in Valdosta, GA is seeking an Eligibility Advocate to assist BH hospital patients with Medicaid applications, screening for eligibility and coordinating the enrollment process to secure coverage. The role supports uninsured/underinsured patients through hospital referrals and follow-up with agencies.

You will document actions in the company system, manage caseloads, comply with HIPAA and policies, travel as needed, and work with hospital teams to ensure timely processing and invoicing.

Qualifications

• High school diploma or GED.
• 1–3 years of related experience in advocacy or customer service.
• Case management experience and knowledge of Medicaid/SSDI is a plus.
• Experience with hospital billing systems (Meditech, EPIC, Allscripts, MS4, etc.) preferred.
• Strong communication and documentation skills; bilingual English/Spanish is required for some positions.

Responsibilities

• Screen clients for Medicaid eligibility and assist with applications.
• Document actions in company database and maintain caseload.
• Coordinate referrals and invoicing; follow up with agencies.
• Travel to various locations for training, facility coverage, home visits.
• Ensure compliance with HIPAA and state/federal regulations.
• Provide excellent customer service and maintain records.

Skills

Advocacy

Customer service

Case management

Documentation

Time management

Organizational skills

Bilingual EN/ES

MS Office

Education

High school diploma or GED

Tools

Meditech

EPIC

Allscripts

MS4

Job description

Location: (On-site) 5 days per week in Valdosta, GA

At Revecore, our work helps hospitals recover the revenue they've earned so they can continue serving patients and communities. Trusted by more than 1,300 hospitals across 48 states, we combine specialized expertise with proprietary technology to solve problems others can’t. Just as importantly, we’ve built a workplace where people support one another, embrace innovation, and are trusted to do their best work.

The Role:

This position is primarily responsible for effectively assisting clients in a Behavioral Health (BH) Hospital Setting in securing medical coverage by screening clients for eligibility and completing Medicaid applications with the clients. Assist uninsured and underinsured patients secure healthcare benefits by conducting screening applications on patient referrals received from the hospital. Effectively assist patients in securing medical coverage by screening referred patients and coordinating the application process through successful approval and invoicing. Follow-up with social service agencies and other third-party eligibility services will also be required.

As an Eligibility Advocate, you will:

• Follows established Company protocol and procedures on case load management for active and approved.
• Documents Company database with action that was taken on the account/application in a timely manner. Effectively and accurately follows established work procedures and guidelines to be efficient in the Medicaid application processes. Includes application completion, collection of all documentation, including detailed case comments.
• Maintains a current caseload according to Company protocol.
• Attends any company and/or facility compliance training, as well as training put on by the State of Colorado.
• Complies with all company policies as well as state and federal regulations including, but not limited to attendance, performance, patient privacy, system security and safety.
• Maintains knowledge of all State Medicaid and CHP+ policy information/guidelines/training.
• Locates, understands, and interprets written information in a variety of formats including such documents such as manuals, reports, graphs, etc.
• Uses own vehicle to travel to various locations for reasons including, but not limited to, outside training, facility coverage, home visits, and agency visits.
• Uses reference material available on Company resource sites, HCPF website, and other web-based sites effectively and regularly.
• Effectively uses computer systems to include but not limited to Company database system, and hospital system.
• Effectively documents and demonstrates a performance standard of 85 consistently.
• Assist with the entry of all referrals and account documentation.
• Contact and screen patients for eligibility. Screenings are completed in the hospital, by phone, and occasionally in patient’s home.
• Complete and copy all relevant applications.
• Gather all required verification documents and submit them to appropriate agencies by the deadline for processing.
• Follow up with agencies to ensure submitted applications are processed in a timely manner.
• Assist in appealing denied applications.
• Update all hospital and company systems with current activity and notes.
• Submit verified billing numbers to facilities.
• Provide hospital with all requested information in a timely manner.
• Complete assigned invoicing functions including capturing claim bill dates, payment dates and payment amounts, from hospital system and assigning appropriate invoice fee types.
• Comply with all state and federal regulations and company policies that include but not limited to patient privacy (HIPAA).
• Perform various other duties, as assigned.
• Comply with the company's code of conduct.
• Additional duties and responsibilities as assigned.

You will be successful if you have:

• High school diploma or general education degree (GED);
• One to three years of related experience such as advocacy and customer service and/or training; or equivalent combination of education and experience.
• Case management experience and working knowledge of State and Federal programs such as Medicaid and Social Security Disability, is a plus,
• Experience with hospital billing systems (Meditech, EPIC, Allscripts, MS4, etc.) desired.
• Past advocacy experience or experience with helping others through enrollment processes is a positive.
• Must be comfortable working directly with patients in an inpatient hospital room environment, especially behavioral health patients.
• Ability to quickly and accurately capture heavy documentation requirements in both the company and hospital computer systems
• MS Office proficiency
• Strong typing and documentation skills
• Exemplary customer service
• Strong written and verbal communication skills
• Strong time management and organizational skills
• Bilingual English / Spanish is required for some positions

#LI-DNI

Revecore is an Affluent Action/Equal Opportunity Employer committed to providing equal employment opportunities for all applicants and employees. We make employment decisions without regard to any characteristic protected by applicable law and encourage individuals of all backgrounds to apply.

Employment is contingent upon eligibility to work in the United States, verification of employment history, and successful completion of a background check.