Eligibility Specialist 1

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

The role of the Eligibility Specialist works either remotely or in one of our Savista service centers, client sites or outreach locations to help identify financial assistance programs for the uninsured or underinsured transferring to other facilities or programs. Provides assistance with the application process and referrals to all State and Federally funded assistance programs, including but not limited to Medicare, Medicaid, Disability and Charity programs.

Essential Duties & Responsibilities

• Interviewing applicants and determining eligibility for benefits or assistance.
• Providing case management services to a high volume of caseloads of patients by completing an assessment and determining initial eligibility.
• Facilitates the application process or directs the patient to the next appropriate step.
• Submit applications and supporting documentation to the appropriate institution in accordance with company protocol and deadlines.
• Following up with the patient, hospital, state/federal programs and receiving facility for missing requirements.
• Responding to all inquiries and concerns timely.
• Act as an advocate for the patient, but also serves as a liaison to other colleagues, client hospital personnel, and government agency staff in a collaborative effort to establish eligibility coverage for future and incurred medical expenses.
• Communicating with other institutions for fact-checking
• Referring households to outside community resources if needed
• Provide superior customer service and maintains a professional image.
• Meet or exceed established productivity, quality, and revenue metrics.
• Entering all required data into computer systems
• Organizing files accurately
• Follow-up with any other tasks or duties as assigned
  
  

Minimum Qualifications & Competencies

• High school diploma or GED.
• At least (3) years of working knowledge and experience with Medicaid programs.
• Prior experience working in a customer service role, interacting directly with customers either in-person or over the phone which includes negotiating, interviewing, explaining and gathering information, gathering and compiling data, analysis of data and/or performance of mathematical or legal tasks.
• Experience working in a role that requires prioritization while ensuring quality and achievements of performance metrics.
• Ability to handle sensitive information and maintain HIPAA compliance.
• Practice in a role that requires accessing multiple databases simultaneously or managing multiple open screens to gather information to discuss with a customer.
• Ability to take initiative and work independently when appropriate.
• Proven time management skills.
• Understanding of meeting deadlines
• Typing skills of 40 wpm
• Proficient with Internet Explorer and Microsoft Office.
• Maintain acceptable attendance and schedule requirements.
• Able to work holidays
• Flexible work schedule
  
  

Preferred Requirements & Competencies

• College Degree preferred.
• Bilingual in English and Spanish (or any other languages)
• Understand federal or state government agencies including Social Security, Medicaid or charity care, healthcare accounts receivable within the healthcare revenue cycle touching patient accounts.
  
  

Core Values And Culture Expectations

Demonstrates integrity and ethics in day-to-day tasks and decision making, adheres to SAVISTA’s core values of courage, authenticity, respect, excellence and service, operates effectively in the Savista environment and the environment of the work group, maintains a focus on self-development and seeks out continuous feedback and learning opportunities.

Physical Demands

The physical demands and work environment are in hospital bedside patient rooms. This would be meeting with patients with infectious diseases. We provide all PPE, and our employee safety is most important.

• Mental Demands: the employee must be able to follow directions, to get along with others, and handle stress.
• Work environment: The noise level in the work environment is usually minimal.
  
  

Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $13.13 to $18.00. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

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