Financial Eligibility Advisor

Saint Peters Healthcare System•New Brunswick, NJ

7d•$20 - $32

About The Position

The Financial Eligibility Advisor will interview patients in person or by telephone to determine eligibility for New Jersey Charity Care, New Jersey Medicaid, and other governmental assistance programs. This role involves conducting comprehensive financial screenings for uninsured and underinsured patients in accordance with Uncompensated Care Trust Fund Regulations. The advisor will meet with patients and families to obtain, verify, and analyze detailed financial, demographic, and residency information based on exact regulatory criteria. They will navigate multiple internal and external systems for eligibility determination, application submission, and follow-up. Additionally, the advisor will educate patients on program requirements, documentation responsibilities, timelines, and potential outcomes, performing all interactions with professionalism, empathy, cultural sensitivity, and confidentiality. The role includes completing related forms and applications for assistance, ensuring accurate and timely submission of Charity Care, Medicaid, and other assistance applications. Maintaining a complete, accurate, and systematic set of records, including thorough documentation for all financial screenings, determinations, and applications, is crucial. The advisor will also ensure timely submission of financial adjustments and supporting documentation to support accurate patient accounts and reimbursement.

Requirements

At least one (1) year experience working in a Hospital Revenue Cycle environment preferred.
In-depth working knowledge of New Jersey Charity Care, New Jersey Medicaid eligibility requirements, Uncompensated Care Trust Fund Regulations, HIPAA, EMTALA, and related state and federal assistance programs.
Demonstrated ability to conduct complex financial and needs-based assessments involving income, assets, household composition, immigration-related eligibility rules, and supporting documentation.
Exceptional interpersonal, communication, and cultural-competency skills required to effectively counsel patients and families during periods of stress, illness, or financial hardship.
High level of analytical ability and attention to detail necessary to ensure accurate determinations while maintaining strict compliance with hospital, state, and federal regulations.
Strong written and electronic documentation skills, including proficiency in navigating hospital registration, billing, and eligibility systems.
Bilingual proficiency (English/Spanish) strongly preferred to ensure equitable access to services for diverse patient populations.
Flexibility to cover multiple hospital sites and adapt to changing regulatory requirements and patient volumes.

Nice To Haves

At least one (1) year experience working in a Hospital Revenue Cycle environment.
Bilingual proficiency (English/Spanish)

Responsibilities

Interview patients in person or by telephone and determines eligibility.
Conduct comprehensive financial screenings for uninsured and underinsured patients to determine eligibility for New Jersey Charity Care, New Jersey Medicaid, and other governmental assistance programs in accordance with Uncompensated Care Trust Fund Regulations.
Meet with patients and families to obtain, verify, and analyze detailed financial, demographic, and residency information based on exact regulatory criteria.
Navigate multiple internal and external systems required for eligibility determination, application submission, and follow-up.
Educate patients regarding program requirements, documentation responsibilities, timelines, and potential outcomes.
Perform all interactions with professionalism, empathy, cultural sensitivity, and confidentiality while completing financial registration processes.
Complete related forms and applications for assistance.
Complete and submit Charity Care, Medicaid, and other assistance applications accurately and within required timeframes.
Assist patients in completing applications and obtaining necessary supporting documentation.
Complete written financial evaluations within established turnaround standards.
Maintain a complete, accurate and systematic set of records.
Maintain thorough, accurate, and compliant documentation for all financial screenings, determinations, and applications.
Ensure timely submission of financial adjustments and supporting documentation to support accurate patient accounts and reimbursement.