Medicaid Investigator

Northwell Health

13h

About The Position

Assists patient/family in completing Medicaid application. Assesses patient's eligibility for Medicaid. Verifies patient's information to complete application. Coordinates with various agencies and individuals to resolve individual cases. Provides information regarding Medical Center regulations and policies pertaining to medical coverage.

Requirements

High School Diploma or equivalent, required.
Minimum of two (2) years experience in financial planning and assessment, with regard to Medicaid and third party reimbursement sources.
Ability to evaluate, research and document financial histories of patients in relation to Medicaid regulations.
Good writing, organizational, interviewing and advocacy skills are essential.
Demonstrated ability to operate data entry equipment, required.
Ability to work well under pressure.
Heavy customer service/telephone contact.

Responsibilities

Contacts patient/family and conducts interviews for the purpose of assessing Medicaid eligibility.
Meets with and assists patient/family in completing Medicaid applications in order to ensure coverage for Hospital, Nursing Facility, Home Care services and community Medicaid.
Checks patient account for pervious balances and advises patient of all financial obligations.
Informs patient of Medical Center's collection policy.
Contacts physicians, nurses, social workers, employers, banks, etc to obtain appropriate medical, legal and financial information to complete Medicaid application.
Notifies appropriate hospital staff regarding Medicaid eligibility status and determination.
Coordinates with various city and county agencies to resolve individual cases.
Answers the telephone and maintains files.
Informs Supervisor of activities, issues and problem cases.
Accumulates data for performance reports.
Maintains departmental files and statistical logs.
Enters data into Medical Center's patient registration system, financial management system, as well as, Medical Eligibility Program database.
Assists in scheduling patients for clinical visits, pre-admission testing, special tests and consultations via Medicaid screening process.
Performs related duties as required.