Role Summary :
Patient Service (Eligibility) Representatives work onsite with our hospital client staff, patients and other team members while interviewing patients to determine program eligibility.
Patient Eligibility Representatives conduct analysis of patients' potential reimbursement and partner with patients to ensure complete understanding of benefits application process.
Patient Eligibility Representatives partner with team members and client to ensure that patients' and client’s needs are met.
Role Responsibilities :
- Meet with under-insured or uninsured patients to explore & identify all possible eligibility program solutions / options
- Obtain and review referrals daily to determine appropriateness for potential interview and eligibility, begin application process when possible
- Interview patients; conduct analysis of potential reimbursement, and determine eligibility
- Introduce services, sets expectations for process and communication to ensure patient understanding
- Partner with patients to ensure patient understanding of process and assist with any questions during the application process
- Obtain and manage all needed forms from patients, and follow up throughout process
- Identify any additional patient needs and direct them to appropriate agencies for assistance
- Leverage technology and account processing workflows; maintains data integrity with accurate and concise documentation in systems
- Serve as intermediary for client, account reps and managers, while interacting with team members and hospital staff in a productive, cooperative manner
- Provide strong client service and collaboration with the team
- Understand and agree to role-specific information security access and responsibilities
- Ensure safety and confidentiality of data and systems by adhering to the organizations information security policies
- Read, understand and agree to security policies and complete all annual security and compliance training
Role Requirements :
- 2+ years customer service experience
- Medicaid experience strongly preferred
- Fluent in Spanish (speak, read, write) a Plus!
- Must be able to work onsite at hospital facility
- Must be able to work required schedule.
- Outstanding communication skills and desire to provide excellent customer service
- A strong concept of patient advocacy and the desire to help someone every day
- A strong work ethic, ability to work independently while making a difference
- Strong computer skills and the ability to multitask while working in a fast-paced environment
- A positive outlook and eagerness to learn
- Consistent punctuality and attendance
- Healthcare experience, and patient contact experience a strong plus
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