Onsite Springfield - Inpatient Eligibility Specialist

MHM Support Services; Town of Springfield (WI); On-site; USD 25,000 - 32,000; Full time

Job summary

Mercy Co. seeks a detail-oriented facilitator to interview uninsured patients in a hospital setting to determine eligibility for State Medicaid benefits and Financial Assistance.

The role includes guiding patients through the application process, collecting documents, and communicating eligibility clearly in person. This on-site position requires strong customer service, knowledge of Medicaid plans, and the ability to build positive relationships with patients while coordinating with hospital

Qualifications

• 1-2 years in healthcare, social work, or case management with patients regarding financial concerns.
• Experience with self-pay, underinsured, or compromised populations in face-to-face customer service.
• Understanding of Revenue Cycle functions including billing, payments, denials, authorizations, and benefit verifications.
• Knowledge of health insurance requirements and medical terminology.
• Ability to explain various state Medicaid plans and patient benefits clearly.

Responsibilities

• Interview uninsured/under-insured patients in a hospital setting to determine Medicaid eligibility.
• Assist patients in the hospital with the Medicaid/Financial Assistance application processes and ensure timely submission of documents.
• Explain the eligibility process and benefits to patients and obtain necessary signatures on State forms.
• Coordinate with patients to gather required documents and communicate what is needed to complete applications.

Skills

Customer service

Communication

Documentation

Multitasking

Face-to-face interaction

Financial assistance navigation

Relationship building

Education

High School Diploma or GED

Job description

Find your calling at Mercy! Interviews uninsured/under-insured patients in a hospital setting to determine eligibility for State Medicaid benefits and Financial Assistance. Requires assisting patients in hospital rooms with the application processes to facilitate accurate and appropriate application submission. Requires building a positive relationship with the patient and communication of the eligibility process and the benefits of having Medicaid coverage. Oversight of signatures on State forms and clear communication regarding the additional documents the patient will need to provide to complete the application is central to this role. This position is in the facility and is not remote.

Position Details

Employment Qualifications: Minimum Education: High School Diploma or GED Minimum years and type of experience: 1-2 years of experience in the healthcare industry, social work, or case management environment, interacting with patients regarding financial concerns, working with self-pay, underinsured, or a compromised population in a face-to-face customer service capacity proactively explaining complicated programs. Other knowledge, skills and abilities preferred: Understanding of Revenue Cycle functions including billing, payments, denials, authorizations, and benefit verifications. Knowledge of health insurance requirements. Knowledge of medical terminology. Patient access experience with managed care/insurance knowledge. Ability to comprehend various state Medicaid plan qualifications and communicate patient benefits clearly and effectively to those most likely to benefit. Good math skills and ability to identify best program for an applicant out of those available. Complete written applications with patients to submit to state agencies and ensure the supporting documents will be provided timely. Customer service ability, strong face to face communication skills, background working with customers or patients on document completion and applications, knowledge of medical expenses and associated bills, knowledge of patient insurance, ability to multitask, ability to learn complex state requirements for programs and explain to patients, bias for action, patient/consumer-focused, entrepreneurial and commitment to excellence and service.

Why Mercy?

From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.

Transforming the Health of Our Communities

Our Mercy health system was founded by the Sisters of Mercy in 1986. But our heritage goes back more than 195 years. It began with an Irish woman named Catherine McAuley, who was determined to help women and children in Dublin experiencing poverty. Though Catherine had a modest upbringing, she received an unexpected inheritance that allowed her to fulfill that dream. In 1827, she opened the first House of Mercy in Dublin, intending to teach skills to women and educate children. Many volunteers came to help. A few years later, Catherine founded the Sisters of Mercy, one of the first religious orders whose Sisters were free to walk among the poor and visit them in their homes. In 1843, the Sisters of Mercy came to the United States. In 1856, they traveled to St. Louis. In the years to come, they would establish hospitals throughout the Midwest. Many of these would join together in 1986 as Mercy.