Medicaid Eligibility Specialist

HCA Healthcare; Lehigh Acres (FL); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Comprehensive benefits

Wellbeing support

Time off & family leave

401(k) with 100% match on up to 3–9%

Job summary

HCA Healthcare is seeking a Medicaid Eligibility Advocate in Florida to screen patients for insurance coverage, assess financial needs, and counsel on benefits and co-pays. This role acts as a liaison between patients, the hospital, and government agencies and participates in all case management areas.

The position involves obtaining documentation, re-verifying benefits, filing applications, and maintaining accurate records in the hospital system.

Qualifications

• Associate degree preferred
• Minimum of one-year related experience with Medicaid or Disability claims preferred, preferably in healthcare.
• Relevant education may substitute experience requirements.

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 degree

Education substitution

Job description

HCA Healthcare is seeking a Medicaid Eligibility Advocate in Florida to screen patients for insurance coverage, assess financial needs, and counsel on benefits and co-pays. This role acts as a liaison between patients, the hospital, and government agencies and participates in all case management areas.

The position involves obtaining documentation, re-verifying benefits, filing applications, and maintaining accurate records in the hospital system.