Eligibility Advocate

Company: Kemberton Healthcare
Location: Colorado Springs
Posted on: January 12, 2021

Job Description:

Description:
POSITION SUMMARY:Assist un-insured and under-insured patients secure healthcare benefits by conducting screening applications on patient referrals received from the hospital. Effectively assist patients in securing medical coverage by screening referred patients and coordinating the application process through successful approval and invoicing. Follow-up with social service agencies and other third-party eligibility services will also be required.PRIMARY DUTIES AND RESPONSIBILITIES MAY INCLUDE ANY OR ALL OF THE FOLLOWING:

• Assist with the entry of all referrals and account documentation
• Contact and screen patients for eligibility. Screenings are completed in the hospital, by phone, and occasionally in patient's home
• Complete and copy all relevant applications
• Gather all required verification documents and submit to appropriate agencies by deadline for processing
• Follow up with agencies to ensure submitted applications are processed in a timely manner
• Assist in appealing denied applications
• Update all hospital and company systems with current activity and notes.
• Submit verified billing numbers to facilities
• Provide hospital with all requested information in a timely manner
• Complete assigned invoicing functions including capturing claim bill dates, payment dates and payment amounts, from hospital system and assigning appropriate invoice fee types.
• Comply with all state and federal regulations and company policies that include but not limited to patient privacy (HIPAA)
• Uses own vehicle to travel to various locations for reasons including, but not limited to, outside training, facility coverage, home visits, and agency visits.
• Perform various other duties, as assigned
• Comply with company's code of conduct.
• Additional duties and responsibilities as assigned.WORKING CONDITIONS:
  • Office environment with some exposure to external environment, temperature changes, uneven walking services.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • The noise level in the work environment is usually moderate..
    
    Requirements:
    PHYSICAL REQUIREMENTS
    • Talking: Frequently conveying detailed or important instructions or ideas accurately, clearly, or quickly.
    • Hearing: Able to hear average or normal conversations and receive ordinary information.
    • Repetitive motion: Frequent and regular use of the wrists, hands, and fingers to make small movements such as typing or picking up small objects. Normal fine and gross motor control of fingers and hands.
    • Seeing: Visual acuteness necessary for the proper evaluation of or to prepare, inspect documents or other materials. Ability to accurately view computer monitors.
    • Physical: Frequent sitting, standing and walking. Occasional lifting up to 25 lbs, pushing and pulling up to 45 lbs. Occasional kneeling, stooping, and bending at the waist.POSITION QUALIFICATIONS AND REQUIREMENTS:Education:
      • High school diploma or general education degree (GED);Experience:
        • One to three years related experience such as advocacy and customer service and/or training; or equivalent combination of education and experience.
        • Case management experience and working knowledge of State and Federal programs such as Medicaid and Social Security Disability is a plus
        • Experience with hospital billing systems (Meditech, Emdeon, etc.) desired
        • Past advocacy experience or experience with helping others through enrollment processes is a positiveKnowledge, Skills, Abilities and Competencies:
          • Must be comfortable working directly with patients in an inpatient hospital room environment
          • Ability to quickly and accurately capture heavy documentation requirements in both the company and hospital computer systems
          • MS Office proficiency
          • Strong typing and documentation skills
          • Exemplary customer service
          • Strong written and verbal communication skills
          • Strong time management and organizational skills
          • Bilingual English / Spanish is required for some positions PI127888279

Keywords: Kemberton Healthcare, Colorado Springs , Eligibility Advocate, Other , Colorado Springs, Colorado