Medicaid Eligibility Advocate

HCA Healthcare•Portsmouth, NH

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 actively in case management. The position is with Portsmouth Regional Hospital, part of HCA Healthcare, and supports Parallon’s revenue cycle management services. The advocate evaluates patients for existing insurance coverage, government assistance programs, and hospital charity applications; verifies benefits and obtains authorizations or referrals before treatment begins; secures required signatures and eligibility documentation; and completes and files applications. The role also follows up with patients and government caseworkers, ensures accurate entry of insurance, demographic, and eligibility information, documents progress in patient files and hospital systems, participates in required training, and assists with other office functions. Field visits may be required, and reliable personal transportation must be readily available. The schedule is Saturday and Sunday, 10:00 a.m. to 6:30 p.m. An associate’s degree and at least one year of related experience are preferred; relevant education may substitute for experience. Benefits eligibility may vary by location.

Requirements

Reliable personal transportation must be readily available for field visits as necessary.

Nice To Haves

Associate’s degree preferred.
Minimum one year of related experience preferred, preferably in healthcare; relevant education may substitute for the experience requirement.

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 is discussed and before treatment begins.
Obtain required signatures on forms.
Obtain legally relevant medical evidence, physician statements, and other documentation needed for eligibility determinations.
Complete and file applications.
Follow up with patients and government agency caseworkers to support timely processing and completion of applications and documentation.
Obtain and accurately enter insurance, demographic, and eligibility information into the system.
Document progress notes in patient files and the hospital computer system.
Participate in ongoing comprehensive training 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.

Benefits

Medical, prescription drug, dental, vision, behavioral health, and telemedicine coverage.
Wellbeing support, including free counseling and referral services.
Paid time off, 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 and 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.