At HealthFund Solutions, we are an advocate for the uninsured and the underinsured patients and a partner to hospitals and healthcare providers.
With decades of experience in the healthcare field, we observed a rising need to help a percentage of the population that continues to grow every day-those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need to get back on their feet.
Reporting to the Eligibility Director, the Eligibility Manager is responsible for overseeing the daily operations and HealthFund Solutions employees of the assigned hospital site.
Responsibilities:
Screen bedside inpatient and observation patients for Federal, State, County Indigent, or other types of eligibility funding for healthcare services including Sponsorship
Screen in person or by phone Emergency Room patients for Federal, State, County Indigent, or other types of eligibility funding for healthcare services including Sponsorship
Complete and file the appropriate application for Federal, State, County Indigent, or other types of eligibility funding for healthcare services
Submit appropriate sponsorship referral if applicable
Gather and submit all supporting documentation needed for the appropriate program
Monitor account until a determination has been made
File the appropriate hearing if needed
Communicate on a regular basis with patients, hospital staff or upper management
Provide technical assistance on agency issues, services, and programs
Monitor accounts to make sure accurate insurance information is added
Address with hospital staff any billing issues that need corrected
Develop and retain a professional relationship with HFS staff and hospital staff
If not on-site, monthly visits need to be made
May require working evenings, weekends, and some holidays
Other duties assigned by Upper Management
Requirements:
High school required
Associate's degree preferred
Thorough knowledge and understanding of Florida Medicaid and Social Security Disability eligibility criteria
Florida Medicaid and Social Security Disability application experience preferred
Ability to maintain and respect confidentiality and HIPPA guidelines
Highly effective in working with a diverse group of people
Must demonstrate communication, organizational, and administrative skills
Excellent time management skills
Ability to self-direct work
Effective stress coping skills
Bilingual preferred
The ability to communicate clearly and concisely is required
Excellent verbal and written communication skills
Must have valid driver's license with clean driving record and active auto insurance
Physical Abilities:
While performing the duties of this job
Ability to sit for long periods of time entering data into the computer
Ability to occasionally lift up to 10 pounds
Ability to concentrate and stay on task for long periods of time
NOTE: This job description is not intended to be all-inclusive. Employee may perform other duties as required to meet the ongoing needs of the organization.