Eligibility Specialist (5564)
About The Position
This position is for an Eligibility Specialist whose responsibility is to support LRMC’s access, enrollment, and financial navigation efforts by identifying uninsured, self-pay, underinsured, and financially vulnerable patients who may qualify for Medicaid, hospital financial assistance, medication assistance, or other community-based support programs. This role will conduct real-time eligibility screenings, assist patients with application and recertification processes, gather required documentation, and coordinate referrals to appropriate benefit programs, including Medicaid, SNAP, prescription assistance, and other social support resources. Working closely with the IP/ER Care Coordinators, Patient Access, Financial Counseling, and Centralized Scheduling teams, the Eligibility Specialist will help reduce financial barriers that prevent patients from obtaining follow-up care, prescriptions, preventive services, and chronic disease management. This position will improve payer conversion, reduce uncompensated care, strengthen continuity of care, and support long-term sustainability by helping eligible patients move from self-pay status into appropriate coverage or assistance programs.
Requirements
- Education level equivalent to completion of four (4) years of high school preferred.
- Completion of Hometown Health University online classes required.
- Prior collection experience working in a hospital/healthcare billing setting preferred.
Nice To Haves
- College level courses helpful.
Responsibilities
- Identifying uninsured, self-pay, underinsured, and financially vulnerable patients who may qualify for Medicaid, hospital financial assistance, medication assistance, or other community-based support programs.
- Conducting real-time eligibility screenings.
- Assisting patients with application and recertification processes.
- Gathering required documentation.
- Coordinating referrals to appropriate benefit programs, including Medicaid, SNAP, prescription assistance, and other social support resources.
- Reducing financial barriers that prevent patients from obtaining follow-up care, prescriptions, preventive services, and chronic disease management.
- Improving payer conversion.
- Reducing uncompensated care.
- Strengthening continuity of care.
- Supporting long-term sustainability by helping eligible patients move from self-pay status into appropriate coverage or assistance programs.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
