Eligibility Caseworker-Daytona Beach, Fl.

HealthFund Solutions LLC; Daytona Beach (FL); On-site; USD 34,000 - 46,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

Life Insurance

Short-Term and Long-Term Disability

Critical Illness & Accident Plans

401(k) with up to 4% employer match

Job summary

HealthFund Solutions LLC, located at a hospital facility in Daytona Beach, FL, seeks a Caseworker for Medicaid and Disability to secure funding for patients. You will assist with forms, screen eligibility for Medicaid, Disability, and ACA Marketplace insurance, and coordinate with hospital staff.

The role requires handling multiple programs, managing a large caseload, and may involve evenings, weekends, and some holidays. Equal opportunity employer with comprehensive benefits.

Qualifications

• Knowledge of Florida Medicaid eligibility criteria.
• Experience with Florida Medicaid/Disability applications preferred.
• Ability to communicate clearly with diverse patients and staff.

Responsibilities

• Complete approximately 5-8 new self-pay screenings bedside daily.
• Collect all required documentation and review patient information to determine patient eligibility.
• Perform all discharge screenings by phone.
• Provide program options that HealthFund Solutions can assist in applying for the patient.
• File all applications that the patient might be eligible for within 24 hours.
• Follow-up on all pending documents for each file.
• Follow-up on previously filed applications until approved.
• Maintain accurate files & notes in hospital software and HealthFund Solutions database.

Skills

Florida Medicaid knowledge

Disability application experience

Bilingual in Spanish

HIPAA compliance

Strong communication & organization

Education

High school diploma or GED

Associate's degree preferred

Job description

Description

Reporting to the Eligibility Manager, the Caseworker for Medicaid and Disability will complete tasks related to securing eligible healthcare funding for patients through programs such as Medicaid, Social Security, County Indigent, and other available funding sources. This role involves helping patients and their families complete necessary forms, applications, and paperwork. Caseworkers will screen patient eligibility in-person, bedside and via phone, determining their qualification for various Federal, State, and County programs, including Medicaid, Disability, and ACA Marketplace Insurance. This position is located at a hospital facility in Daytona Beach, Fl. The schedule is Monday-Friday 8:00am-4:30pm EST.

Benefits:

• Medical, Dental, and Vision Insurance
• Life Insurance
• Short-Term and Long-Term Disability
• Critical Illness & Accident Plans
• 401(k) with up to 4% employer match

Responsibilities:

• Complete approximately 5-8 new self-pay screenings bedside daily
• Collect all required documentation and review patient information to determine patient’s eligibility
• Perform all discharge screenings by phone
• Provide program options that HealthFund Solutions can assist in applying for the patient
• File all applications that the patient might be eligible for within 24 hours
• Follow-up on all pending documents for each file
• Follow-up on previously filed applications until approved
• Review all documents before sending to Federal/State/or County agencies for accuracy and completeness
• Submit required documentation
• Immediately after screening the patient, IF they meet sponsorship qualifications send referrals to Sponsorship
• Review application denials with management
• Maintain accurate files & notes on actions taken to be recorded in hospital software and HealthFund Solutions database
• Communicate with patients and hospital staff (written and verbal)
• Maintain and update database as new information becomes available
• Manage large caseload to completion
• Develop and retain a professional relationship with HFS staff and hospital staff
• Will require working evenings, weekends, and some holidays
• Other duties assigned by Management

Qualifications & Skills:

• Highschool required
• Associate’s degree preferred
• Thorough knowledge and understanding of Florida Medicaid eligibility criteria
• Full Cycle Florida Medicaid application experience preferred
• Disability application experience preferred both Medicaid and Social Security
• Ability to maintain and respect confidentiality and HIPAA guidelines
• Highly effective in working objectively with a diverse group of people and must demonstrate communication, organizational, administrative, and time managers ability to read and comprehend simple instructions
• Ability to self-direct work
• Effective stress coping skills
• Bi-lingual with Spanish preferred
• Ability to communicate clearly and concisely is required
• Excellent verbal and written communication skills
• May require working evenings, weekends, and some holidays
• Experience with Florida Family Medicaid, Medicaid Disability, Social Security Disability and filing DCF applications preferred
• Florida DCF experience a plus

NOTE: This job description is not intended to be all-inclusive. Duties may be adjusted as needed to meet organizational needs.

All candidates must successfully pass a national background check and a 12-panel drug screening. HealthFund Solutions is a drug-free workplace.

We are an equal opportunity employer. All qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status