Eligibility Specialist

Easterseals MORC•Auburn Hills, MI

About The Position

Easterseals MORC is hiring for an Eligibility Specialist to help make a difference and become part of something bigger than yourself! We are looking for Game Changers! The types of people who wake up excited to make a difference. The superheroes of their field who care about the people they serve. If that sounds like you, we want you on our team.

Requirements

Determine financial liability
Complete financial determinations
Verify and research insurance information
Enter insurance benefits on-line to the department’s billing system
Allocate charges to first party payers
Produce first party bills
Maintain accounts receivable
Conduct special studies and surveys
Gather financial information for determination of ability to pay for cost of care
Contact financial institutions, insurance companies and governmental agencies and programs
Determine and enroll consumers in benefit programs
Reimburse for mental health services provided
Testify at appeal hearings
Collect and review consumer information
Obtain and maintain Medicaid coverage
Provide liaison activities with governmental agencies, consumers, providers, parents/guardians and others regarding reimbursement matters
Research services to meet consumer’s monthly Medicaid deductibles
Prepare reports
Monitor Department of Human Services processing activity
Review monthly Medifax report
Process financial determinations
Generate letters and financial liability notification
Provide verification of shelter expenses quarterly
Secure food stamps
Verify residential placements
Ensure appropriate benefits
Compile and prepare confidential reports, correspondence and other documents
Review and maintain accounts receivable and billing records
Follow-up with first party payers for payment
Make recommendations to supervisor as to uncollectible first party accounts
Determine and recommend financial liability, payment plans, and county liability
Review quarterly A/R report for accuracy and collection of outstanding balances
Work cooperatively with multiple departments
Maintain contact with customers
Deliver customer related services and reports within specific timeframes
Coordinate customer related services
Meet individual needs and expectations
Render services in a dependable and reliable manner
Conduct all interactions with customers with dignity and respect
Assist and direct visitors within the agency

Responsibilities

Interviews consumers, families, guardians, service providers, employers and various governmental agencies to obtain information to determine financial liability
Completes financial determinations, verifies and researches insurance information and enters all insurance benefits on-line to the department’s billing system to allocate charges to first party payers, produce first party bills and maintain accounts receivable
Conducts special studies and surveys in such areas as feasibility of offering new services, improvement of efficiency and economy
Gathers financial information for the determination of ability to pay for cost of care
Contacts financial institutions, insurance companies and various governmental agencies and programs to determine and enroll consumers in benefit programs to reimburse for mental health services provided
Testifies at appeal hearings regarding financial liability
Collects and reviews consumer information to obtain and maintain Medicaid coverage
Provides liaison activities with governmental agencies, consumers, providers, parents/guardians and others regarding reimbursement matters
Researches services to meet consumer’s monthly Medicaid deductibles, prepares reports and monitors Department of Human Services processing activity
Reviews monthly Medifax report to ensure Medicaid coverage is maintained
Processes financial determinations at least annually, which includes generating letters and financial liability notification to appropriate parties
Provides verification of shelter expenses quarterly to the Department of Human Services to secure food stamps, in Consumer Finance Assistant’s absence
Verifies residential placements to ensure appropriate benefits
Compiles and prepares confidential reports, correspondence and other documents
Reviews, and maintains accounts receivable and billing records for follow-up with first party payers for payment
Makes recommendations to supervisor as to uncollectible first party accounts
Determines and recommends financial liability, payment plans, and county liability for consumers receiving mental health services
Reviews quarterly A/R report for accuracy and collection of outstanding balances
Works cooperatively with multiple departments to ensure A/R accuracy
Maintains contact with customers including but are not limited to: Consumer, families, and guardians; Providers; Employees
All customer related services and reports are delivered within specific timeframes as established by standards of practice
All customer related services are coordinated and meet the individual’s needs and expectations
Services are rendered in a dependable and reliable manner
All interaction with customers are conducted with dignity and respect
Assists and directs visitors within the agency

Benefits

Low-cost Dental/Health/Vision insurance
Dependent care reimbursement
Up to 5 days paid FMLA for maternity, paternity, foster care and adoption
Generous 401K retirement plan
Paid Leave Options Available
Up to $125 bonus for taking 5 days off in a row
10 paid holidays and 3 floating holidays (Over 30 days total of paid time off)
Wellness Programs
PSLF (Public Service Loan Forgiveness) Employer
Bonuses and extra incentives to reward hard work & dedication
Mileage reimbursement in accordance with IRS rate
Free financial planning services through our partnerships with the LoVasco Consulting Group, and SoFi
Student loan repayment options
Pet Insurance