Medicaid Eligibility Advocate

HCA Healthcare•Hermitage, TN

About The Position

The Medicaid Eligibility Advocate conducts eligibility screenings, assesses patients’ financial requirements, and counsels patients on insurance benefits and co-payments. The role serves as a liaison among patients, the hospital, and governmental agencies and participates in all areas of case management. The advocate screens patients for existing insurance coverage, federal and state assistance programs, and hospital charity applications. The role verifies benefits and obtains authorization or referrals after the treatment plan has been discussed and before treatment begins. It also obtains required signatures and supporting medical and other documentation, completes and files applications, and follows up with patients and government agency caseworkers to support timely processing. The advocate accurately obtains and enters insurance, demographic, and eligibility information; documents progress in patient files and the hospital computer system; participates in required training; follows office policies and procedures; and assists with other office functions as requested. Field visits may be required, and reliable personal transportation must be readily available.

Requirements

Minimum one year of related experience preferred; relevant education may substitute for the experience requirement.
Reliable personal transportation readily available for field visits as necessary.

Nice To Haves

Associate’s degree preferred.
Related experience, preferably in healthcare.

Responsibilities

Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, and hospital charity applications.
Re-verify benefits and obtain authorization and/or referrals after the treatment plan has been discussed and before treatment begins.
Ensure required signatures are obtained on necessary forms.
Obtain legally relevant medical evidence, physician statements, and other documentation required for eligibility determination.
Complete and file applications.
Follow up with patients and government agency caseworkers to ensure timely processing and completion of applications and supporting documentation.
Obtain and accurately enter insurance, demographic, and eligibility information into the system.
Document progress notes in the patient’s file and hospital computer system.
Participate in ongoing, comprehensive training programs as required.
Follow policies and procedures to contribute to office efficiency.
Cover and assist with other office functions as requested.
Make field visits as necessary; have reliable personal transportation readily available.

Benefits

Medical, prescription drug, dental, vision, behavioral health, and telemedicine coverage.
Wellbeing support, including free counseling and referral services.
Paid time off and paid family leave.
Long- and short-term disability coverage and leaves of absence.
401(k) plan with a 100% match on 3% to 9% of pay, based on years of service.
Employee Stock Purchase Plan.
Flexible spending accounts.
Preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
Tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
Fertility and family-building benefits and adoption assistance.
Life insurance and supplemental health protection plans.
Auto and home insurance, legal counseling, identity theft protection, and consumer discounts.