Medicaid Eligibility Advocate

Schuylkill; Allentown (Lehigh County); On-site; USD 42,000 - 54,000; Full time

Job summary

Lehigh Valley Health Network is seeking a Medicaid Eligibility Counselor to assist patients and families with Medicaid applications, eligibility determinations, and documentation. You will coordinate with legal representatives, government agencies, and care teams to ensure timely submissions while protecting patient confidentiality.

The role emphasizes compliance with HIPAA and state/federal regulations, requires strong communication and organizational skills, and offers a supportive environment

Qualifications

• Associates degree or equivalent experience in healthcare admin or related field.
• 2 years in healthcare financial counseling, Medicaid eligibility, patient access, or related area.
• Knowledge of Medicaid eligibility, reimbursement, and revenue cycle operations.
• Strong communication and customer service skills for sensitive situations.
• Proficiency with EMR, MS Office, and eligibility verification tools.
• Excellent organization, analytical, and problem-solving abilities.
• Ability to manage multiple priorities in a fast-paced setting.
• Understanding of HIPAA and healthcare regulations and collaboration across teams.

Responsibilities

• Outreach to patients and families to obtain Medicaid documentation.
• Educate on Medicaid eligibility requirements and deadlines.
• Collect and verify financial, legal, and personal documents.
• Prepare and track Medicaid applications for timely filing.
• Maintain detailed records of interactions and case outcomes.
• Collaborate with attorneys, social workers, and agencies to resolve issues.
• Monitor applications and follow up on outstanding requirements.
• Support reimbursement optimization through successful enrollment outcomes.
• Ensure compliance with Medicaid regulations and HIPAA.

Skills

Communication skills

Interpersonal skills

Customer service

Organizational skills

Time management

HIPAA knowledge

Education

Associates degree in Healthcare Administration / related field

Bachelor's degree preferred

Tools

EMR

Microsoft Office

Eligibility verification systems

Job description

Lehigh Valley Health Network is seeking a Medicaid Eligibility Counselor to assist patients and families with Medicaid applications, eligibility determinations, and documentation. You will coordinate with legal representatives, government agencies, and care teams to ensure timely submissions while protecting patient confidentiality.

The role emphasizes compliance with HIPAA and state/federal regulations, requires strong communication and organizational skills, and offers a supportive environment