Eligibility Caseworker-Daytona Beach, Fl.

HealthFund Solutions; Daytona Beach (FL); On-site; USD 38,000 - 60,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

Life Insurance

Disability Insurance

Critical Illness & Accident Plans

401(k) with 4% match

Job summary

HealthFund Solutions seeks a Caseworker for Medicaid and Disability in a Daytona Beach hospital setting. You will help patients secure funding by screening eligibility for Medicaid, Disability, and related programs, and by guiding them through required forms and paperwork.

You will manage a large caseload, collaborate with hospital staff, and ensure timely submission of applications. Evening/weekend work may be required; bilingual Spanish is a plus.

Qualifications

• Knowledge of Florida Medicaid eligibility criteria.
• Experience with Florida Medicaid application processes.
• Experience with Disability applications (Medicaid and Social Security).
• Ability to maintain confidentiality and follow HIPAA guidelines.
• Strong communication and organizational skills.
• Bilingual Spanish preferred.

Responsibilities

• Screen patients for Medicaid, Disability, and ACA programs.
• Assist patients with completing forms and applications.
• Review documents for accuracy before submission to agencies.
• Coordinate with hospital staff and departments.
• Maintain patient files in hospital software and HealthFund Solutions database.
• Follow up on pending documents and approvals.
• Work evenings, weekends, and some holidays.

Skills

Bilingual Spanish

Communication skills

Organizational skills

Time management

HIPAA knowledge

Education

High school diploma

Associate degree

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