Eligibility Manager-Daytona Beach, Fl.

HealthFund Solutions•Daytona Beach, FL

3d•Hybrid

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. This role involves managing staff, ensuring compliance with eligibility criteria, and maintaining effective communication with both hospital and HFS staff. The position requires strong organizational, administrative, and communication skills, as well as a thorough understanding of Florida Medicaid and Social Security Disability.

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