Eligibility Caseworker-Daytona Beach, Fl.

HealthFund Solutions LLC•Daytona Beach, FL

2d•Onsite

About The Position

Reporting to the Eligibility Manager, the Caseworker for Medicaid and Disability completes tasks related to securing eligible healthcare funding for patients through Medicaid, Social Security, County Indigent, and other available funding sources. The role helps patients and their families complete forms, applications, and other paperwork. The caseworker screens patient eligibility in person, at bedside, and by phone, determining qualification for Federal, State, and County programs, including Medicaid, Disability, and ACA Marketplace Insurance. This position is located at a hospital facility in Daytona Beach, Florida. The schedule is Monday through Friday, 8:00 a.m.–4:30 p.m. EST. The role may also require evenings, weekends, and some holidays. Candidates must pass a national background check and a 12-panel drug screening. HealthFund Solutions is a drug-free workplace. The employer is an equal opportunity employer.

Requirements

High school education required.
Thorough knowledge and understanding of Florida Medicaid eligibility criteria.
Ability to maintain and respect confidentiality and HIPAA guidelines.
Ability to work objectively with a diverse group of people.
Communication, organizational, administrative, and time-management abilities.
Ability to read and comprehend simple instructions.
Ability to self-direct work.
Effective stress-coping skills.
Clear and concise communication; excellent verbal and written communication skills.
Must successfully pass a national background check and a 12-panel drug screening.

Nice To Haves

Associate’s degree preferred.
Full-cycle Florida Medicaid application experience preferred.
Medicaid and Social Security disability application experience preferred.
Bilingual Spanish preferred.
Experience with Florida Family Medicaid, Medicaid Disability, Social Security Disability, and filing DCF applications preferred.
Florida DCF experience is a plus.

Responsibilities

Complete approximately 5–8 new self-pay screenings at bedside each day.
Collect required documentation and review patient information to determine eligibility.
Perform discharge screenings by phone.
Explain program options that HealthFund Solutions can assist the patient in applying for.
File all applications for which the patient may be eligible within 24 hours.
Follow up on pending documents for each file.
Follow up on previously filed applications until they are approved.
Review documents for accuracy and completeness before sending them to Federal, State, or County agencies.
Submit required documentation.
Refer patients who meet sponsorship qualifications to Sponsorship immediately after screening.
Review application denials with management.
Maintain accurate files and notes on actions taken in hospital software and the HealthFund Solutions database.
Communicate with patients and hospital staff in writing and verbally.
Maintain and update the database as new information becomes available.
Manage a large caseload through completion.
Develop and maintain professional relationships with HealthFund Solutions and hospital staff.
Perform other duties assigned by management.