Medicaid Eligibility Specialist I

🕒 3 dias atrás

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FreedomCare

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

🏥 Saúde

⚕️ Seguro de Saúde

🌍 Impacto Social

Healthcare • Healthcare Insurance • Social Impact

FreedomCare é um provedor de cuidados domiciliares em rápido crescimento nos Estados Unidos, financiado pelo Medicaid. A empresa oferece um serviço de cuidado domiciliar único que permite aos pacientes escolher seus cuidadores, que podem ser um membro da família ou amigo, garantindo que eles sejam pagos prontamente após seus turnos através de um aplicativo prático. Operando em vários estados, incluindo Nova York, Nevada, Missouri, Pensilvânia, entre outros, a FreedomCare se concentra em fornecer cuidados confiáveis no conforto da casa do paciente, melhorando a satisfação e reduzindo visitas hospitalares. Seu programa se destaca pela alta satisfação do cliente e pelo número de avaliações positivas, refletindo o impacto e a eficácia de seus serviços em melhorar o bem-estar de cuidadores e pacientes.

Descrição

• Develop in-depth understanding of FSSA programs, benefits, eligibility requirements, and enrollment processes • Serve as the subject matter expert for Medicaid eligibility questions • Verify patient eligibility for Medicaid benefits using online systems and tools • Assist patients with preliminary review of Medicaid application documentation and requirements • Confirm coverage details and determine patient benefits according to Medicaid guidelines • Investigate eligibility issues, deferrals, denials, and recertifications and recommend resolutions • Maintain accurate records of verification processes and outcomes • Update patient records in Salesforce with current Medicaid status • Respond to Medicaid inquiries from clients, caregivers, health plan partners, patients, and healthcare providers • Explain Medicaid eligibility, benefits, and application processes • Advocate for clients to receive appropriate Medicaid services • Collaborate with departments, case managers, and healthcare professionals to support patient access to benefits • Assist with training staff on Medicaid verification procedures and policies

🎯 Requisitos

• Minimum of 2 years of experience in healthcare, insurance verification, or a related field • Associate degree or higher in healthcare administration, business, or a related field preferred • Experience with Medicaid verification and understanding of Medicaid regulations highly preferred • Strong customer focus and adaptability in a high call volume environment • Customer service skills, including empathy, active listening, and patience • Effective written and verbal communication skills for diverse audiences • Ability to multitask, set priorities, and manage time effectively • Technical proficiency navigating multiple systems while maintaining data accuracy • Fluency with role-specific tools and resources, with heavy reliance on Excel • Ability to embrace change and departmental growth in an evergreen environment

🏖️ Benefícios

• Competitive compensation • Medical benefits • Retirement plans • Wellness programs • Fun company events • Ongoing learning opportunities to grow your career • Remote work arrangement • Equal Opportunity Employer and inclusive environment