Health Financial Resource Specialist (PN 20014055 & PN 20014054)

Ohio Department of Administrative Services•Columbus, OH

About The Position

The Complex Medical Help program is looking to fill 2 Health Finance Resource Specialist positions that will provide critical support to families and providers by evaluating financial eligibility and connecting individuals to essential health care resources and programs.

Requirements

Formal education in arithmetic that includes fractions, decimals & percentages
12 months training or 12 months experience in budgeting
12 months training or 12 months experience in public relations
6 months training or 6 months experience in interviewing
Official educational transcripts are required for all post-high school educational accomplishments, coursework or degrees claimed on the application.

Nice To Haves

Associate's or advanced degree in Accounting or Finance
Experience in determining financial eligibility for government programs (e.g., Medicaid, Title 20, food stamps)
Experience providing technical assistance or consultation to customers
Experience reviewing medical expense reports, out of pocket payments and determining validity of expense for cost sharing
Experience with various categories of Medicaid and providing direct referrals of clients as appropriate
Experience working with Provider Network Management (PNM) system
Experience coordinating private health insurance and other third-party resources to determine payment responsibility

Responsibilities

Review and evaluate financial applications, documentations and eligibility criteria for health assistance programs.
Determine financial eligibility and cost share responsibilities for applicants and recipients.
Analyze income, insurance, and demographic information to support accurate eligibility decisions.
Communicate with families to request additional information, clarify requirements, and guide them through the application process.
Coordinate referral to appropriate local, state, and federal assistance programs and community resources.
Collaborate with internal staff, healthcare providers, and external agencies to support access to services.
Enter and maintain accurate data in automates eligibility and case management systems.
Monitor applications compliance and ensure adherence to program policies and guidelines.
Review reconsideration requests and provide recommendations to leadership.
Educate families, providers, and partner organizations on program eligibility, processes and available resources.
Maintain up-to-date knowledge of applicable programs, regulations and resource networks.