Eligibility Specialist 2

Savista•Pembroke, FL

1d•Remote

About The Position

The Eligibility Specialist II is a critical advocate for patients, helping uninsured and underinsured individuals access financial assistance for medical care. This role involves conducting detailed assessments, guiding patients through application processes for government and charity-funded programs and ensuring compliance with healthcare regulations. Successful candidates are empathetic, detail-oriented, and skilled at navigating complex systems to support patients in receiving the care they need.

Requirements

High school diploma or GED
Proficiency in English and Spanish
At least 2 years of experience in a customer-facing role, preferably in healthcare or financial counseling.
Flexibility to provide support to multiple hospital locations and in-home patient visits within assigned market area as based on operational needs.
Strong organizational skills with the ability to handle multiple priorities and maintain accuracy and attention to detail.
Excellent verbal and written communication skills, with the ability to explain complex information clearly and empathetically.
Ability to identify solutions to financial challenges, leveraging program knowledge to benefit patients.
Capability to work in a fast-paced environment with changing priorities and patient needs.
Demonstrated ability to work independently in locations where potentially only one Eligibility Specialist is assigned.
Demonstrate genuine care for patients’ needs and concerns, building trust and rapport.
Work effectively with colleagues, hospital staff, and external agencies to achieve shared goals.
Ensure all documentation is accurate, complete, and submitted on time.
Reliable internet connection and a secure workspace.

Nice To Haves

Experience in healthcare revenue cycle, financial counseling, or insurance verification.
Experience with multiple EHR systems: Epic, Cerner, Meditech, etc.
Familiarity with state and federal assistance programs such as Medicaid, Medicare, and Social Security Disability.
Knowledge of medical terminology and healthcare accounts receivable processes.

Responsibilities

Conduct advanced eligibility screening to assess financial assistance eligibility and provide compassionate guidance on available programs.
Facilitate the application process for programs such as Medicaid, Medicare, Disability, hospital charity care or unique requirements for non-traditional funding, ensuring timely submission of accurate documentation
Act as a liaison between patients, hospital staff, and government agencies to establish eligibility, secure funding and resolve coverage issues.
Perform advanced follow-up work across, ensuring applications are complete and processed efficiently.
Identify and assist with technical medical requirements for disability programs, including setting up medical appointments, completing disability applications, submitting appeals, and following through on resolution of applications.
Manage multiple patient cases independently, prioritizing tasks to meet deadlines and ensure effective follow-up on pending applications.
Clearly communicate financial obligations, funding options, and program details to patients in an empathetic and professional manner.
Maintain accurate and confidential records in compliance with HIPAA and organizational policies.
Consistently achieve productivity and quality metrics, contributing to the organization's financial counseling objectives.
Efficiently use multiple systems and databases to gather, track, and report on patient data.
Identify and assist with complex cases, including disability applications, setting up appointments, and submitting appeals, etc. as needed.
Assist in training and supporting colleagues as needed, ensuring seamless onboarding and service delivery.
Complete special projects, as assigned.