Eligibility Manager-Daytona Beach, Fl.

HealthFund Solutions LLCDaytona Beach, FL
$63,000 - $65,000Hybrid

About The Position

The Eligibility Manager is responsible for overseeing the daily operations and HealthFund Solutions employees of the assigned hospital site in Daytona Beach, Fl.

Requirements

  • High school required
  • Thorough knowledge and understanding of Florida Medicaid and Social Security Disability eligibility criteria
  • Ability to maintain and respect confidentiality and HIPPA guidelines
  • Highly effective in working with a diverse group of people
  • Must demonstrate communication, organizational, and administrative skills
  • Excellent time management skills
  • Ability to self-direct work
  • Effective stress coping skills
  • The ability to communicate clearly and concisely is required
  • Excellent verbal and written communication skills
  • Must have valid driver’s license with clean driving record and active auto insurance
  • Remote/Hybrid – at any point, if required to work from home a minimum internet speed of 75Mbps and reliable cellular signal is required to be able to do this job effectively
  • Ability to sit for long periods of time entering data into the computer
  • Ability to occasionally lift up to 10 pounds
  • Ability to concentrate and stay on task for long periods of time
  • All candidates must successfully pass a national background check and a 12-panel drug screening.

Nice To Haves

  • Associate’s degree preferred
  • Florida Medicaid and Social Security Disability application experience preferred
  • Bilingual preferred

Responsibilities

  • Attend and facilitate hospital meetings and conference calls
  • Send follow-ups and rollovers to caseworkers daily
  • Send out agenda for weekly staff meetings to management
  • Report callouts, timecard corrections, and tardiness to the Eligibility Assistant Director
  • Facilitate disciplinary action meetings with staff members
  • Assist with patient refusals by communicating actions and updates to hospital leadership
  • Review Rollover Report and assign all rollovers to the appropriate staff member
  • Complete and send QA Reviews
  • Audit accounts
  • File and attend hearings as needed
  • Communicate on a regular basis with hospital staff or upper management
  • Report on any technical issues with different agencies, services, and programs
  • Address with hospital staff any billing issues that need to be corrected (i.e. Charity reversal)
  • Develop and retain a professional relationship with HFS staff and hospital staff
  • Work Open MCD and Commercial Insurance discovery daily
  • Make weekly visits to other assigned facilities
  • May require working evenings, weekends, and some holidays
  • Assist onsite caseworkers with screening or submitting applications as needed
  • Other duties as assigned by Upper Management

Benefits

  • Medical, Dental, and Vision Insurance
  • Life Insurance
  • Short-Term and Long-Term Disability
  • Critical Illness & Accident Plans
  • 401(k) with up to 4% employer match
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