Medicaid Eligibility Advocate

HCA Healthcare; McAllen (TX); On-site; USD 38,000 - 58,000; Full time

Benefits offered by this job

Comprehensive health benefits

401(k) with match

Education and tuition assistance

Paid time off and disability coverage

Job summary

HCA Healthcare is seeking an Medicaid Eligibility Advocate in Texas to assess patient financial needs, screen for insurance coverage, and counsel patients on benefits and copays. The role functions as a liaison among patients, the hospital, and government agencies, contributing to all areas of case management.

Responsibilities include verifying benefits, collecting documentation, and filing eligibility applications while maintaining accurate records and complying with policies.

Qualifications

• Counsel patients on insurance benefits and co-payments.
• Screen and verify patient eligibility for federal/state programs.
• Document progress notes and enter data into the hospital system.

Responsibilities

• Screen and evaluate patients for insurance coverage or charity programs.
• Re-verify benefits and obtain necessary signatures and referrals.
• Obtain medical evidence and documentation for eligibility decisions.
• File applications and coordinate follow-up with agencies for timely processing.
• Enter demographic and eligibility data accurately in the system; maintain patient files.
• Participate in ongoing training and support office operations.

Skills

Counseling patients

Verbal communication

Education

Associate’s degree preferred

Relevant education may substitute experience

Job description

Schedule: Monday - Friday; 11:00am - 7:30pm

Job Summary and Qualifications

The Medicaid Eligibility Advocate is responsible for conducting eligibility screenings, assessing patient financial requirements, and counseling patients on insurance benefits and co‑payments. The role serves as a liaison between the patient, hospital, and governmental agencies and is actively involved in all areas of case management.

Responsibilities

• Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, or hospital charity applications.
• Re‑verify benefits and obtain authorization and/or referral after the treatment plan has been discussed, prior to initiation of treatment. Ensure appropriate signatures are obtained on all necessary forms.
• Obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination.
• Complete and file applications, initiating and maintaining proper follow‑up with the patient and government agency caseworkers to ensure timely processing and completion of all mandated applications and accompanying documentation.
• Ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately. Document progress notes to the patient’s file and the hospital computer system.
• Participate in ongoing, comprehensive training programs as required.
• Follow policies and procedures to contribute to the efficiency of the office. Cover and assist with other office functions as requested.
• Will be required to make field visits as necessary and will need reliable personal transportation readily available.

Qualifications

• Associate’s degree preferred.
• Minimum one‑year related experience preferred, preferably in healthcare.
• Relevant education may substitute the experience requirement.

Benefits

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services.
• Well‑being support, including free counseling and referral services.
• Time away from work programs for paid time off, paid family leave, long‑ and short‑term disability coverage and leaves of absence.
• Savings and retirement resources, including a 401(k) plan with a 100% match on 3% to 9% of pay (based on years of service), an employee stock purchase plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial well‑being counseling.
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing.
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts.

Note: Eligibility for benefits may vary by location.

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.