Medicaid Eligibility Advocate

Summary:

The Medicaid Eligibility Advocate coordinates and facilitates the Medicaid application process across multidisciplinary entities to obtain Medicaid eligibility for patients entitled to Medicaid to attain reimbursement for services provided by Jacksonville Children’s & Multispecialty Clinic.  The Medicaid Eligibility Advocate also acts as a liaison between the patient, organization, and governmental agencies. 

Essential Functions:

• Screen and evaluate patients for existing insurance coverage and federal and state assistance programs. 
• Complete and file applications. Initiate and maintain proper follow-up with the patient and government agency caseworkers to ensure timely processing and completion of all mandated applications and accompanying documentation. 
• Ensure all insurance, demographic, and eligibility information is obtained and entered into the system accurately. Document progress notes to the patient’s file. 
• Work in conjunction with the organization’s Revenue Cycle & Billing teams as needed. 
• Maintain knowledge and understanding of local community resources. 
• Participates in ongoing, comprehensive training programs as required. 
• Follows policies and procedures to contribute to the efficiency of the office. Covers and assists with other office functions as requested. 
• Assist management in forecasting by providing historical information. 
• Excellent verbal and written communication skills 
• Sound judgment 
• Efficient 
• Self-starter 
• Strong customer service and interpersonal communication skills 
• Knowledge of basic accounting and accounts receivable 
• Accurate data entry skills with knowledge of basic keyboarding 
• Professional and courteous telephone skills 
• Ability to file numerically and alphabetically 
• Knowledge of confidentiality and release of information 
• Ability to work independently and under pressure, handling multiple tasks simultaneously 
• Ability to work as a team member and in conjunction with all other team members in a helpful, positive manner 
• Ability to project a positive and professional image to the community 
• Ability and willingness to collect money from patients  

Minimum Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.  

• Associate degree preferred 
• Minimum of one-year related experience in healthcare. 
• Relevant education may substitute experience requirements. 

Knowledge, Skills, and Abilities: 

• Must have thorough education or training on NC Medicaid programs and eligibility 
• The employee must be able to understand, communicate, and react effectively to the unique needs of pediatric, adolescent, adult, and geriatric patients. 
• Self-motivated, analytical, quick learner, organized, detail-oriented, multi-tasker.   

Physical Demands  

Standing, sitting, walking, stooping, stretching, reaching, kneeling, talking, lifting.  
 

Work Environment   
 In an office, climate-controlled setting with direct interactions with patients and staff in person and by phone.  
 

The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required for the position.  All employees may have other duties assigned at any time.  

 Benefits:  

• 401(k)  
• Health, Dental, and Vision insurance  
• Employee assistance program  
• AFLAC
• Paid time off