Medicaid Eligibility Advocate

HCA Healthcare • Marion, NC

2d

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 government agencies and participates in case management activities.

The advocate evaluates patients for existing insurance coverage, federal and state assistance programs, and hospital charity applications. The role verifies benefits and obtains authorizations or referrals after the treatment plan is discussed and before treatment begins. It also obtains required signatures, medical evidence, physician statements, and other eligibility documentation; completes and files applications; and follows up with patients and government agency caseworkers to support timely application processing.

The advocate ensures insurance, demographic, and eligibility information is accurately entered into the system and documents progress in patient files and the hospital computer system. The role includes required ongoing training, following office policies and procedures, assisting with other office functions as requested, and making field visits when necessary. Reliable personal transportation must be readily available.

Requirements

• Reliable personal transportation readily available for necessary field visits.
• Relevant education may substitute for the experience requirement.

Nice To Haves

• Associate’s degree preferred.
• At least one year of related experience preferred, 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 authorizations or referrals after the treatment plan has been discussed and before treatment begins.
• Obtain all necessary signatures on required forms.
• Obtain legally relevant medical evidence, physician statements, and other documentation required for eligibility determinations.
• Complete and file applications.
• Follow up with patients and government agency caseworkers to support timely processing and completion of applications and required documentation.
• Ensure insurance, demographic, and eligibility information is obtained and entered accurately into the system.
• Document progress notes in patient files and the 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.

Benefits

• Medical, prescription drug, dental, vision, behavioral health, and telemedicine plans.
• 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, 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed