Inpatient Eligibility Specialist-Remote-STL

Mercy Co; Chesterfield (MO); Remote; USD 42,000 - 62,000; Full time

Job summary

Mercy is seeking an Inpatient Eligibility Specialist to join our remote call center team. You will guide uninsured and under-insured patients through Medicaid and Financial Assistance applications by phone with empathy and accuracy.

Responsibilities include collecting required information, educating patients on eligibility options, ensuring timely follow-ups, and documenting submissions to support approvals in our healthcare system.

Qualifications

• Minimum Education: High School Diploma or GED.
• 1-2 years of experience in healthcare/social work/case management interacting with patients about financial concerns.
• Knowledge of Medicaid eligibility and health insurance basics is preferred.

Responsibilities

• Guide patients through Medicaid and Financial Assistance applications by phone.
• Explain eligibility options clearly and educate patients on required documentation.
• Ensure timely follow-up and accurate system documentation to support approvals.

Skills

Customer service

Healthcare revenue cycle

Medicaid knowledge

State plan qualifications

Accurate documentation

Communication

Education

High School Diploma or GED

Job description

Find your calling at Mercy!

Provides virtual support to uninsured and under-insured patients to determine eligibility for Medicaid and Financial Assistance programs. This role operates in a remote call center environment and is responsible for guiding patients through the application process by phone.
Builds rapport with patients through clear, compassionate, and professional communication while educating them on eligibility options and the benefits of coverage. Assists patients in completing applications accurately, ensures all required information is obtained, and provides clear instructions on documentation needed to support submission.
Maintains accountability for timely follow-up, complete application processing, and accurate system documentation to support successful approvals.

Position Details:

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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