Medicaid Investigator

Job Description

Assists patient/family in completing Medicaid application. Assesses patient's eligibility for Medicaid. Verifies patient's information to complete application. Coordinates with various agencies and individuals to resolve individual cases.

Job Responsibility

• * Provides information regarding Medical Center regulations and policies pertaining to medical coverage
• * Contacts patient/family and conducts interviews for the purpose of assessing Medicaid eligibility.
• * Meets with and assists patient/family in completing Medicaid applications in order to ensure coverage for Hospital, Nursing Facility, Home Care services and community Medicaid.
• * Checks patient account for pervious balances and advises patient of all financial obligations.
• * Informs patient of Medical Center's collection policy.
• * Contacts physicians, nurses, social workers, employers, banks, etc to obtain appropriate medical, legal and financial information to complete Medicaid application.Notifies appropriate hospital staff regarding Medicaid eligibility status and determination.
• * Coordinates with various city and county agencies to resolve individual cases.
• * Answers the telephone and maintains files.Informs Supervisor of activities, issues and problem cases.Accumulates data for performance reports.
• * Maintains departmental files and statistical logs.Enters data into Medical Center's patient registration system, financial management system, as well as, Medical Eligibility Program database.
• * Assists in scheduling patients for clinical visits, pre-admission testing, special tests and consultations via Medicaid screening process.
• Performs related duties as required.

*ADA Essential Functions

Job Qualification

• High School Diploma or equivalent, required.
• Minimum of two (2) years experience in financial planning and assessment, with regard to Medicaid and third party reimbursement sources.
• Ability to evaluate, research and document financial histories of patients in relation to Medicaid regulations.
• Good writing, organizational, interviewing and advocacy skills are essential.
• Demonstrated ability to operate data entry equipment, required.
• Ability to work well under pressure. Heavy customer service/telephone contact.

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).