Inpatient Eligibility Specialist
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Job Description
Inpatient Eligibility Specialist role providing virtual support to uninsured and under-insured patients for Medicaid and Financial Assistance programs. Guides patients through application processes and eligibility options via phone.
Responsibilities:
- Provides virtual support to uninsured and under-insured patients to determine eligibility for Medicaid and Financial Assistance programs
- Operates in a remote call center environment
- Responsible for guiding patients through the application process by phone
- Builds rapport with patients through clear, compassionate, and professional communication
- Educates patients on eligibility options and benefits of coverage
- Assists patients in completing applications accurately
- Provides clear instructions on documentation needed to support submission
- Maintains accountability for timely follow-up and complete application processing
Requirements:
- 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
- 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
- Good math skills
- Customer service ability
- Strong face to face communication skills
- Background working with customers or patients on document completion and applications
- Ability to multitask
- Ability to learn complex state requirements for programs and explain to patients
Benefits:
- medical, dental, and vision coverage
- paid time off
- tuition support
- matched retirement plans for team members working 32+ hours per pay period
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