|Location||Monroe County Hospital - Georgia|
The Eligibility Coordinator is responsible for securing financial coverage for all patients with or without limited insurance and alternate payment sources.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
- Interviews, corresponds with, and counsels the patient and/or patient’s family regarding information relative to insurance, employment, and the financial ability to pay.
- Assist the patient with identifying and obtaining alternative sources of payment.
- Reviews and verifies patient’s insurance.
- Verifies insurance benefits prior to admission for all planned admissions and as soon as reasonably possible after admission for all emergencies.
- Coordinates pre-certification process between hospital and physician offices to ensure that all required procedures and surgery pre-certifications are completed in a timely manner.
- Responsible for collecting deductibles, co-insurance, and co-pays.
- Responsible for arranging payment plan for patients that are unable to settle account on discharge based on current hospital policies and procedures.
- Initiates pre-certification process for Emergency Medicaid patients who require CT/MRI procedures.
- Provide referrals to other support services in the local community area for health insurance exchanges and coordinate outreach and enrollment efforts.
- Reviews, updates, and communicates policy changes in regard to Health Insurance Exchanges. Works with community partners to assist patients with obtaining programs through local, state, or federal programs.
- Oversees the Indigent Care Trust Fund (ICTF) and the Rock Springs Clinic program.
- Reviews applications for accuracy and compliance with required regulatory guidelines. Approves applications as appropriate.
- Reviews adjustments made to ICTF spreadsheet and ensures accounts are balanced for each month.
- Reviews all policies that pertain to commercial and governmental insurances to ensure hospital pre-certification requirements are met.
- Knowledgeable of all healthcare plans, coordination of benefits, and coverage available under auto, liability, and homeowner insurance plans.
- Processes outpatient registrations.
- Will cross-train other admissions personnel for cross coverage as necessary.
- Develop constructive and cooperative working relationships with others; ensure flow of communication within department.
This position has no supervisory responsibilities.
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, copiers, filing cabinets, and fax machines.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk or hear. This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets, and bend or stand as necessary.
Position Type/Expected Hours of Work:
This is a full time position. The employee must be available during the “core” work hours of 8:00 am to 4:30 pm and must work 40 hours each week to maintain full time status. Occasional overtime may be required as job duties demand.
Required Education and Experience:
- High School diploma or GED.
- One (1) year of experience in healthcare financial counseling.
- One (1) year of experience in hospital or medical office setting.
- Knowledge of credit collections and insurance programs.
- Must be efficient with keyboarding and computer applications.