Eligibility Specialist

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:

Summary:
The Medicaid Eligibility Specialist coordinates and facilitates the Medicaid application process across multidisciplinary entities to obtain Medicaid eligibility for patients entitled to Medicaid for the purpose of attaining reimbursement for services provided by Nash Health Care Systems.

Responsibilities:

• Advise and instruct patients on the procedures of applying for Medicaid and/or Social Security Disability benefits.
• Follow-up with patient and County DSS to assure all pertinent information has been provided relevant to the applications and that applications are being processed within appropriate timeframes.
  
• Analyzes patient's assets, income and potential for disability; explains the programs and advises patients of methods to reduce reserve in a timely manner based on knowledge of the Medicaid and Social Security regulations.
  
• Evaluates denials and follow through with County DSS contacts and/or patient to determine basis of the denial; evaluate denial and follow through with requesting appeal.
  
• Gathers appropriate documentation, prepares appeal summary and represents the patient at county and state hearings by providing convincing evidence for the purpose of reversing a negative decision with or without the patient's assistance.
  
• Training and Development (includes meeting attendance)

Other Information:

• Associate's degree in business. Years of experience may be substituted for degree. One year of experience for one year of education.
• Bachelor's degree in business, healthcare administration, accounting, finance or a related field is preferred.
• 4 years of experience in Healthcare/Medical - Healthcare - Other or Social Services
• Minimum of four (4) years of related experience in a social services or healthcare organization is preferred.
  

Legal Employer: Nash Hospitals

Entity: Nash UNC Health Care

Organization Unit: NGH Registration Discharge

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: NASH HC

Exempt From Overtime: Exempt: No