What are the responsibilities and job description for the Eligibility Representative II position at DECO Recovery Management?
Company Description
Since 1993, Our team is driven to make the DECO Difference each day!
We believe exceptional efforts produce exceptional results; focusing on a compassionate, empathetic patient-advocacy approach to eligibility services that not only provides hospitals with a targeted revenue flow solution for their uninsured and under-insured populations, but greatly enhances patient satisfaction.
Job Description
Eligibility Representative II will assist the Program Manager in the training process sharing knowledge and skills as directed. Utilizes intermediate customer skills to interact with the basic client representatives. Will perform detailed in-house review and bedside interviews to determine if patient is a viable candidate for State, Federal, County, Medical or Disability Assistance, and if so to assist the patient/guarantor with the application process for any Assistance type program. This assistance will include the necessary investigative, field, and administrative work needed to assist the patient in meeting eligibility requirements for Disability, Medicaid or other applicable County, Federal or State programs if appropriate.
Qualifications
- Explain to patients and other entities the eligibility requirements, application process and verification requirements for applicable programs.
- Screen patients and/or patient’s representative to determine potential eligibility for Third Party Resources.
- Determine potential eligibility for health care coverage in accordance to state/federal/local policies and procedures.
- Document pertinent patient information and account activity in the appropriate systems dictated by the health care facility and ElevatePFS account, as required by ElevatePFS policies and procedures in order to support account dispositions.
- Facilitate the application process when appropriate for the patient by assisting the patient in completing the application, scheduling appointment interviews and obtaining required verifications.
- Monitor patient accounts to ensure appropriate processing timeframes are met.
- Submit accurate information so accounts can be billed appropriately.
- Assist the Program Manager with various projects on an as needed basis.
- Bilingual Spanish is required.
Additional Information
All your information will be kept confidential according to EEO guidelines.
