Medicaid Eligibility Navigator

HCA Healthcare; Asheville (NC); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Comprehensive benefits package

Tuition assistance

401(k) with company match

Life insurance

Employee stock purchase plan

Job summary

Mission Hospital is seeking a Medicaid Eligibility Advocate to conduct eligibility screenings, assess patient financial requirements, and counsel patients on insurance benefits and co-payments. The role acts as a liaison between patients, the hospital, and government agencies and participates in case management.

The position requires evaluating insurance coverage, re-verifying benefits, collecting documentation, and filing applications, with field visits as needed and transportation required.

Qualifications

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

Responsibilities

• Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, or hospital charity applications.
• Re-verifies benefits and obtains authorization and/or referral after treatment plan has been discussed, prior to initiation of treatment. Ensures 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. Initiate and maintain 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.
• Participates in ongoing, comprehensive training programs as required.
• Follows policies and procedures to contribute to the efficiency of the office. Covers and assists with other office functions as requested.
• Will be required to make field visits as necessary and will need reliable personal transportation readily available.

Education

Associate’s degree preferred

Job description

Mission Hospital is seeking a Medicaid Eligibility Advocate to conduct eligibility screenings, assess patient financial requirements, and counsel patients on insurance benefits and co-payments. The role acts as a liaison between patients, the hospital, and government agencies and participates in case management.

The position requires evaluating insurance coverage, re-verifying benefits, collecting documentation, and filing applications, with field visits as needed and transportation required.