Medicaid Eligibility Navigator

HCA Healthcare; Ogden (UT); On-site; USD 40,000 - 65,000; Full time

Benefits offered by this job

Medical benefits

401(k) match

Employee stock purchase plan

Tuition assistance

Fertility & family benefits

Life insurance

Job summary

Mission Hospital, part of HCA Healthcare, seeks a Medicaid Eligibility Advocate to assess patient financial needs and counsel on insurance benefits. You will liaise between patients, the hospital, and government agencies, handling case management tasks and eligibility determinations.

The role involves screening for coverage, obtaining and verifying documentation, and following through with applications and referrals, while maintaining accurate records and participating in training programs.

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, part of HCA Healthcare, seeks a Medicaid Eligibility Advocate to assess patient financial needs and counsel on insurance benefits. You will liaise between patients, the hospital, and government agencies, handling case management tasks and eligibility determinations.

The role involves screening for coverage, obtaining and verifying documentation, and following through with applications and referrals, while maintaining accurate records and participating in training programs.