The Eligibility Services Representative is responsible for providing financial screening at point-of-service with on-site coverage. We qualify all beneficiaries for applicable federal, state and local programs including but not limited to, charity care, Medicaid, ACA counseling, etc. We screen, investigate and assist in the identification/qualification process for all patients on behalf of our clients as a business partner.

Responsibilities:

• Provides superior customer service and maintains a professional image
• Understands and meets the client's needs, internal procedures and goals
• Communicates effectively with multiple constituencies within the facility
• Establishes and maintains strong working relationships

Application Process & Determining Eligibility

• Review referrals and screen for potential eligibility in appropriate federal/state/local program
• Contact patient or their representative to complete the appropriate application and acquire all necessary releases, signatures, documents
• Submit the application and any acquired documentation in a timely manner to the appropriate agency
• Advise the applicant of all additional required documentation needs and time frames for compliance
• Thoroughly enter all actions taken in the client account and in the internal data base/system

Follow-up & Monitoring

• Maintain structured and timely contact with the applicant and responsible government agency
• Assist the applicant with gathering any additional reports or records, meeting appointment dates and times
• As per established protocols, inform the client in a timely manner of all approvals and denials of coverage
• Thoroughly enter all actions taken in the client account and in the internal data base/system

Requirements:

• High School Diploma or GED required
• A minimum of 2 years of relevant experience will train in updates and procedure
• Must be able to work in a team environment
• Superior command of verbal and written skills
• Knowledge of Medicaid and Charity Care and experience in a hospital environment
• Proficient in various computer applications. (*Word, *Excel, Etc.)
• Bilingual - Ability to speak and read Spanish required
• Understanding of NJ Medicaid program to assist individuals in the application process
• Excellent communication skills (oral and written) and organization skills
• Must obtain and maintain required certifications/credentials
• Must be able to travel between local sites on occasion based on client and business needs

Must be reliable, self-directed, and self-motivated and able to work in a fast paced hospital environment.

Benefits:

• Major Medical Insurance
• Flexible Spending Account
• Dental Insurance
• Vision Insurance
• Life Insurance
• Long Term & Short Term disability 100% paid by employer after 1 year
• Voluntary Term Life
• 401(k) Savings Plan
• UNUM Supplemental Insurance
• Paid Holidays
• Paid Time Off