Patient Benefits & Eligibility Specialist

Avenir Senior Living•Surprise, AZ

12d•Onsite

About The Position

Avenir Behavioral Health Center is seeking a compassionate, detail-oriented Patient Benefits & Eligibility Specialist to help uninsured patients obtain healthcare coverage, primarily through AHCCCS/Medicaid. The specialist meets directly with newly admitted patients to assess potential eligibility, assist with application completion and submission, gather necessary documentation, and follow up through the eligibility determination process. The role involves face-to-face interaction with people receiving acute inpatient psychiatric treatment and requires patience, professionalism, organization, and strong communication skills. This is initially a part-time, hourly, non-exempt position. Work is onsite at Avenir Behavioral Health Center in Surprise, Arizona, with scheduling based on operational needs and patient admission volume. The role may be considered for expansion to full-time employment based on workload, operational need, and organizational approval; a transition is not guaranteed. The specialist works with patients, clinical and administrative departments, AHCCCS, the Arizona Department of Economic Security, and other appropriate parties to support accurate and timely applications, eligibility follow-up, and documentation.

Requirements

High school diploma or equivalent required.
One year of experience in healthcare administration, patient registration, insurance enrollment, Medicaid eligibility, patient financial services, or a related field preferred.
Strong interpersonal and communication skills, including the ability to interact professionally with patients experiencing behavioral health challenges.
Excellent organizational skills and attention to detail.
Ability to manage multiple applications simultaneously and consistently follow through on outstanding tasks.
Proficiency with computers, electronic documentation systems, and standard office software.
Ability to maintain confidentiality and handle sensitive personal and financial information appropriately.
Ability to work independently while collaborating effectively with clinical and administrative departments.
Ability to establish rapport with patients from diverse backgrounds and gather information through interviews.
Ability to explain complex application requirements in understandable terms.
Patience, empathy, professionalism, sound judgment, and the ability to recognize when patient participation should be postponed or coordinated with clinical staff.
Strong problem-solving skills and persistence in resolving application-related issues.
Ability to prioritize workload, manage competing deadlines, and work effectively with minimal supervision.
Commitment to accuracy, accountability, and timely follow-through.

Nice To Haves

Experience assisting individuals with AHCCCS/Medicaid applications.
Familiarity with Health-e-Arizona Plus (HEAplus) and Arizona Medicaid eligibility requirements.
Prior experience in an inpatient hospital, behavioral health facility, or healthcare financial services setting.
Knowledge of Medicaid eligibility verification and application follow-up procedures.
Experience working directly with individuals experiencing psychiatric or behavioral health conditions.
Bilingual English/Spanish communication skills.

Responsibilities

Identify newly admitted patients who are uninsured or may qualify for AHCCCS coverage, and meet with them to assess potential eligibility and initiate applications.
Interview patients to gather demographic, financial, employment, residency, and household information required for applications.
Explain eligibility requirements, application procedures, and documentation needs clearly and respectfully; assist patients facing barriers to participation.
Coordinate interview timing with nursing and clinical staff, maintain professional boundaries, and follow hospital safety protocols.
Assist patients in completing and submitting AHCCCS applications through Health-e-Arizona Plus (HEAplus) or other approved methods.
Review applications for accuracy, completeness, and consistency; obtain, organize, and help patients secure supporting documentation, signatures, authorizations, and consents.
Coordinate with legally authorized representatives, guardians, or other appropriate parties when necessary and permitted.
Track applications, monitor status, identify outstanding documentation or deficiencies, and follow up with patients as needed, including after discharge when authorized.
Communicate with AHCCCS, DES, and other appropriate agencies to facilitate processing and resolve outstanding issues.
Document eligibility determinations, coverage effective dates, denials, application activities, patient interactions, and outcomes; communicate progress and determinations to appropriate hospital personnel.
Work with Intake, Case Management, Nursing, Utilization Review, and Billing to identify patients needing enrollment assistance and support accurate insurance documentation.
Assist with resolving AHCCCS-related coverage discrepancies and contribute to efforts to improve application completion, reduce delays, and minimize avoidable uncompensated care.
Protect confidential patient, financial, and personal information; follow HIPAA, hospital policies, and applicable state and federal regulations.
Maintain working knowledge of AHCCCS eligibility criteria and procedures, submit accurate information without misrepresentation, and respect patient rights, dignity, and privacy.
Recognize when clinical conditions may affect a patient's ability to participate and coordinate with clinical personnel as appropriate.
Assist with related patient financial assistance or eligibility activities, participate in meetings, training, and process improvement initiatives, and perform other duties as assigned.