Caseworker

Job Description

At HealthFund Solutions, we are an advocate for uninsured patients and a partner to hospitals and healthcare providers.

With decades of experience in the healthcare field, we observed a rising need to help a percentage of the American population that continues to grow every day—those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need and get back on their feet.

Reporting to the Manager, The Caseworker will coordinate activities to ensure that Medicaid, Social Security, County Indigent, or other types of eligible funding for healthcare services are received for patients. This includes assisting the patients and others (family members) to complete forms, applications, and other paperwork. Caseworkers will screen patient’s bedside and by phone to see if they qualify for Federal, State and County programs which include Medicaid, Disability and ACA Marketplace Insurance.

This is an onsite position that requires the employee to report onsite to their assigned hospital daily, Tuesday-Saturday or Sunday-Thursday 11:00 am to 7:30 pm. This position may require occasional weekends and holidays as needed. This position may be temporarily remote until you are credentialed. This position requires overtime during Open Enrollment and other times throughout the year.

Responsibilities:

• Complete daily screenings bedside and by phone
• File appropriate applications
• Collect, submit and follow-up on required documentation and pending applications
• Enroll patients in ACA marketplace plans and obtain HFS documents for signatures
• Provide guidance and support to patients throughout the enrollment process
• Assist patients in resolving any case issues with the Marketplace and Insurance Companies if they arise
• Stay up to date with changes to the ACA marketplace plans and Medicaid policies
• Daily follow-up on all assigned accounts
• Answer all emails and phone messages as soon as possible but within 24 hours
• Enter all information into HealthFund and Hospital databases
• Document and review patient information within the Electronic Medical Record (EMR)
• Participate in any required meetings and webinars
• Provide any required screening or enrollment data for tracking of conversions
• Responsible for placing calls for patient outreach
• May require occasional evenings and weekends
• Other duties as assigned
  
  

Requirements:

• Thorough knowledge and understanding of Ohio Medicaid eligibility criteria is preferred
• Full Cycle Ohio Medicaid application experience preferred
• Disability application experience preferred, both Medicaid and Social Security
• Ability to maintain and respect confidentiality and HIPAA guidelines
• High School Diploma required
• College Degree or some college preferred
• One (1) to two (2) years of related experience required
• Knowledge of policy and procedures for ACA Marketplace Insurance preferred
• Understanding of copay, co-insurance, and deductibles with commercial insurance preferred
• Ability to communicate effectively verbally and in writing
• Administrative and clerical procedures
• Computer savvy
• Ability to establish and maintain effective working relationships
• Conflict resolution techniques
• Attention to details
• Work effectively with individuals from diverse backgrounds
• Electronic Medical Record (EMR) or Electronic Health Record (EHR) software experience preferred
• Required to complete hospital medical clearance and vaccinations upon hire and annually if applicable
• Must have valid driver’s license with clean driving record and active auto insurance
  
  

Physical Abilities:

While performing the duties of this job

• Ability to sit for long periods of time entering data into the computer
• Ability to occasionally lift up to 10 pounds
• Ability to concentrate and stay on task for long periods of time
  
  

NOTE: This job description is not intended to be all-inclusive. Employee may perform other duties as required to meet the ongoing needs of the organization.

Please note that as we are vendors to several hospital systems. All onsite hospital positions are required to have the COVID vaccination completed prior to start date. If you choose not to vaccinate, you are required to provide a fully executed medical or religious exemption form prior to your start date. Upon approval of that exemption, you would be required to submit to weekly COVID testing. Be aware, that this policy could change at any time.

We are an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

The successful candidate will be required to complete the Form I-9 and that information will be verified using the E-Verify system. E-Verify is operated by the Department of Homeland Security in partnership with the Social Security Administration to verify employment eligibility.

Any candidate offered a position will be required to pass pre-employment screenings which include a national background check and a 12-panel drug screen.

HealthFund Solutions is a Drug -Free Workplace.

Company Description

At HealthFund Solutions, we are advocates for uninsured patients and a partner to hospitals and healthcare providers.

With decades of experience in the healthcare field, we observed a rising need to help a percentage of the American population that continues to grow every day—those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need and get back on their feet.

At HealthFund Solutions, we are advocates for uninsured patients and a partner to hospitals and healthcare providers. With decades of experience in the healthcare field, we observed a rising need to help a percentage of the American population that continues to grow every day—those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need and get back on their feet.