Inpatient Eligibility Specialist

Mercy Hospital St. Louis Critical Care Medicine Fellowship; Ada (OK); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Tuition assistance

Retirement plan

Job summary

Mercy Ada Hospital is seeking an Inpatient Eligibility Specialist to interview uninsured/under-insured patients in the hospital setting and determine Medicaid eligibility. You will assist with the Medicaid/financial assistance applications, explain benefits, and ensure timely submission of required documents.

This role emphasizes strong patient relations and clear communication in a on-site, hospital environment.

Qualifications

• Basic understanding of patient access processes.
• Familiarity with Medicaid or state assistance programs preferred.
• Strong interpersonal and communication skills.

Responsibilities

• Interview uninsured/under-insured patients to determine Medicaid eligibility.
• Assist patients in hospital rooms with the application processes for financial assistance.
• Explain the benefits of Medicaid coverage and required documents clearly to patients.
• Oversee signatures on State forms and communicate needed documents for timely submission.
• Maintain a positive patient relationship and ensure accurate application submission.
• Support patient access and financial counseling activities on-site.

Skills

Patient interaction

Customer service

Communication

Financial assistance knowledge

Education

High School Diploma or GED

Job description

Find your calling at Mercy!

Interviews uninsured/under-insured patients in a hospital setting to determine eligibility for State Medicaid benefits and Financial Assistance. Requires assisting patients in hospital rooms with the application processes to facilitate accurate and appropriate application submission. Requires building a positive relationship with the patient and communication of the eligibility process and the benefits of having Medicaid coverage. Oversight of signatures on State forms and clear communication regarding the additional documents the patient will need to provide to complete the application is central to this role. This position is in the facility and is not remote.

Position Details

• Inpatient Eligibility Specialist
• Full Time - On Site
• Mercy - Ada Hospital

Employment Qualifications

Minimum Education: High School Diploma or GED

Minimum years and type of experience: 1-2 years of experience in the healthcare industry, social work, or case management environment, interacting with patients regarding financial concerns, working with self-pay, underinsured, or a compromised population in a face-to-face customer service capacity proactively explaining complicated programs.

Other Knowledge, Skills And Abilities Preferred

Understanding of Revenue Cycle functions including billing, payments, denials, authorizations, and benefit verifications.

Knowledge of health insurance requirements.

Knowledge of medical terminology.

Patient access experience with managed care/insurance knowledge.

Ability to comprehend various state Medicaid plan qualifications and communicate patient benefits clearly and effectively to those most likely to benefit.

Good math skills and ability to identify best program for an applicant out of those available.

Complete written applications with patients to submit to state agencies and ensure the supporting documents will be provided timely.

Customer service ability, strong face to face communication skills, background working with customers or patients on document completion and applications, knowledge of medical expenses and associated bills, knowledge of patient insurance, ability to multitask, ability to learn complex state requirements for programs and explain to patients, bias for action, patient/consumer-focused, entrepreneurial and commitment to excellence and service.

Why Mercy?

From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.

Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.

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