Eligibility Representative

Are you ready to make a real difference in the lives of our patients? Join our dynamic team as an Eligibility Representative! The Eligibility Representative plays a critical role as the key to unlocking financial assistance for our patients, helping them navigate complex assistance programs right from their bedside. In this position, you'll have the unique opportunity to interact with patients at their bedside, guiding them through the complexities of various assistance programs and providing them with the support they need to access essential benefits. This position involves day and weekend coverage (Monday through Friday 10:30 a.m. to 7 p.m.) and is located onsite at Cedar Park Regional Medical Center - Cedar Park, TX.

Key Responsibilities

• Engage with Patients: Meet self-pay patients at their bedside to evaluate their eligibility for programs like Medicaid, Medicare, and other assistance options.
• Uncover Payment Sources: Investigate and pinpoint all possible payment sources, including auto insurance, Workers' Compensation, commercial insurance, private insurance, and Third Party Liability (TPL).
• Streamline Account Routing: Accurately route patient accounts within our Patient Accounting environment based on identified payor sources, ensuring smooth and efficient processing.
• Financial Documentation: Assist patients in meticulously completing the Confidential Financial Statement form, capturing all necessary information.
• Benefit Application Assistance: Support patients through the application process for various benefits, offering guidance and essential information to help them access available resources.
• Detailed Documentation: Maintain comprehensive and accurate records of all patient interactions, eligibility screenings, and application processes in our systems.
• Continuous Learning: Stay abreast on changes in eligibility criteria, program requirements, and best practices in patient advocacy and support.
• Adherence to Compliance: Uphold all relevant laws, regulations, and hospital policies, ensuring patient confidentiality and privacy at all times.
• Collaborative Efforts: Partner with other hospital departments, such as Patient Access, Case Management, Social Services, Billing, and Patient Advocacy, to provide comprehensive support for our patients.
• Other duties as assigned

Qualifications

Education:

• High school diploma or equivalent required
• Associate’s or Bachelor’s degree in a related field preferred.

Experience:

• Previous experience in a healthcare setting, preferably in patient financial services or a related field.

Knowledge:

• Familiarity with State, Federal, or other assistance programs, insurance verification, and patient accounting processes preferred.

Skills:

• Exceptional communication and interpersonal skills.
• Strong analytical and problem-solving abilities.
• Proficiency in using computer systems and software for documentation and eligibility screening.
• Ability to work independently and manage multiple tasks effectively.
• Compassionate and patient-focused approach to service delivery.
• Bilingual in Spanish required.  

License and Certification:

• Certification Application Counselor (CAC) through the Affordable Care Act (ACA)
• Insurance Navigator license required for residents of GA and IN

Working Conditions

Environment:

• Hospital setting, including Patient Rooms/Emergency Department and Administrative Offices.

Physical Requirements:

• The Employee may be required to occasionally lift a minimum of 25 pounds, climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.
• The Employee is required to read, review, prepare and analyze written data and figures, using a computer or similar.

Ready to make a positive impact on our patients' lives?  Submit your application and resume outlining your qualifications and experience today!  Applications will be reviewed on a rolling basis until the position is filled.

ESS is an Equal Opportunity Employer

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