Eligibility Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct comprehensive eligibility screenings to evaluate financial assistance opportunities and offer compassionate guidance on available programs.

• Facilitate the application process for various programs such as Medicaid, Medicare, Disability, hospital charity care, or specific requirements for non-traditional funding, ensuring accurate documentation is submitted promptly.

• Serve as a liaison between patients, hospital personnel, and government agencies to determine eligibility, secure funding, and resolve coverage issues.

• Perform extensive follow-up to ensure that applications are complete and processed efficiently.

• Identify and assist with technical medical requirements for disability programs, which includes scheduling medical appointments, completing disability applications, submitting appeals, and following through on application resolutions.

• Independently manage multiple patient cases, prioritizing tasks to meet deadlines and ensure thorough follow-up on pending applications.

• Clearly articulate financial responsibilities, funding alternatives, and program specifics to patients in an empathetic and professional manner.

• Keep accurate and confidential records in accordance with HIPAA and organizational policies.

• Consistently meet productivity and quality benchmarks, contributing to the organization's financial counseling objectives.

• Effectively utilize multiple systems and databases to collect, track, and report patient data.

• Identify and assist with complex cases, including disability applications, appointment scheduling, and appeals submissions as necessary.

• Support the training and development of colleagues as needed, ensuring smooth onboarding and service delivery.

• Complete special projects as assigned.

⛳️ Requirements

• High school diploma or GED.

• Minimum of 2 years of experience in a customer-facing role, ideally within healthcare or financial counseling.

• Flexibility to provide support across multiple hospital locations and conduct in-home patient visits as required by operational needs.

• Strong organizational skills with the capacity to manage multiple priorities while maintaining accuracy and attention to detail.

• Excellent verbal and written communication abilities, capable of explaining complex information in a clear and empathetic manner.

• Proficient in identifying solutions to financial challenges, utilizing program knowledge to assist patients effectively.

• Ability to thrive in a fast-paced environment with evolving priorities and patient needs.

• Proven capability to work independently in settings where only one Eligibility Specialist may be assigned.

• Demonstrate genuine concern for patients' needs and issues, fostering trust and rapport.

• Collaborate effectively with colleagues, hospital staff, and external agencies to achieve common objectives.

• Ensure that all documentation is accurate, complete, and submitted timely.

• Reliable internet connection and a secure workspace.

🏝️ Benefits

• Comprehensive health insurance packages.

• Opportunities for professional development and training.

• Flexible working hours and locations.

• Supportive team environment focused on patient care.