Financial Eligibility Specialist

Chase Brexton Health Care• Baltimore, MD, US, MD

51d•$21 - $24•Onsite

About The Position

The Financial Eligibility Specialist determines applicant eligibility for third party reimbursement, processes data necessary for admission of new patients into health services, ensures proper coding for insurance billing, and handles inquiries from prospective applicants and patients. This role is not responsible for Chase Brexton billing discussions or questions not related to Sliding Fee charges.

Requirements

Must become a Certified Application Counselor and complete enrollments through the Maryland Health Benefits Exchange within three (3) months of hire.
Ability to understand and practice bookkeeping and accounting terminology.
Ability to operate computers and other office machines.
Cultural competence and the ability to work with providing individualized care that respects and empowers patients of all ages, races, gender identities, religions, sexual orientations, ethnicities, and socioeconomic statuses.
Must be able to take responsibility and work under pressure.
High School Diploma or GED.
Certified Application Counselor designation within three (3) months of hire.
At least three (3) years of experience with insurance verification and/or sliding fee scale determination.

Nice To Haves

Bilingual preferred.
Training or background in ICD-A / CPT codes preferred.
Knowledge of insurance and billing practices preferred.
Working knowledge of all Maryland insurance programs and eligibility guidelines.
Working knowledge of all Chase Brexton policies and procedures.
Working knowledge of all service areas offered by Chase Brexton.

Responsibilities

Conducts fee scale and insurance eligibility for clients following procedures and guidelines specific to each program.
Calculates and implements the Ryan White Cap.
Reviews relevant reports and follows up to link patients to eligible insurance and/or assistance programs.
Ensures that the client’s fee scale is appropriately applied to any other payer source such as Medicare, Medicaid, MADAP, and any other third-party insurance.
Refers clients to medical case manager should someone be entitled to additional assistance.
Registers clients into CPS and completes Case Management visit notes explaining any referrals or plans.
Completes all necessary paperwork.
Maintains up-to-date and orderly eligibility files.
Provides comprehensive monthly reporting of patient statistics and metrics.
Responds to billing discussions or questions related to Sliding Fee charges.
Conducts renewal eligibility as required by each program.
Participates in workgroups and special projects, as assigned.
Confirms eligibility appointments with clients.
Sets initial service appointments once eligibility has been determined.
Provides clients with a list of required eligibility documentation.
Refers patients to new Chase Brexton services based on patient treatment needs.