Eligibility Specialist – Patient Assistance Programs

About Us

Healthcare Claims Management (HCM) is a mission-driven healthcare Revenue Cycle Management (RCM) organization dedicated to improving financial outcomes for healthcare providers and fostering a positive, transparent patient experience. By combining innovative technology, thorough knowledge of healthcare regulations, and compassionate service, we help underserved communities access the financial support they need.

Job Overview

We are seeking a compassionate, detail-oriented Eligibility Specialist to work on-site in Greenfield, IN. In this role, you will assist patients in navigating various financial assistance and government programs, ensuring they receive the coverage and support necessary for their healthcare needs. The ideal candidate has a background in healthcare, social services, or patient advocacy and possesses excellent communication skills to guide patients through often complex eligibility criteria and applications.

Key Responsibilities

• Patient Assessment & Documentation

• Meet with patients and families to gather financial and medical information for determining eligibility for Medicaid, Medicare, and charitable assistance programs.

• Maintain detailed, confidential patient records, tracking application progress and eligibility decisions in compliance with HIPAA regulations.

• Application Support & Guidance

• Assist patients with completing applications for government programs and charitable organizations, ensuring accurate and timely submission of all required documents.

• Explain eligibility criteria, application processes, and program benefits clearly and empathetically to patients.

• Collaboration & Advocacy

• Collaborate with hospital social workers, case managers, and internal departments to identify patients who need financial assistance or coverage.

• Act as an advocate for patients by communicating with government agencies, charity organizations, and other stakeholders to expedite application approvals and secure financial aid.

• Regulatory Compliance & Program Updates

• Stay informed on program changes related to Medicaid, Medicare, and other government or charitable coverage options, providing up-to-date information to patients and colleagues.

• Educate patients about the appeals process if applications are denied, assisting with reapplications or alternative options when necessary.

• Customer Service & Follow-Up

• Uphold a patient-focused, compassionate approach, ensuring all interactions prioritize dignity and respect.

• Proactively follow up on application statuses, troubleshooting any delays or issues that may impede access to care.

Minimum Qualifications

• Education
• High school diploma or equivalent required; Bachelor's degree in a related field (e.g., Social Work, Healthcare Administration) preferred.
• Experience
• 2 years in a healthcare, social services, or patient advocacy role, with experience in Medicaid and Medicare assistance strongly desired.
• Familiarity with government assistance programs and the ability to navigate complex eligibility criteria.
• Skills & Competencies
• Excellent Communication: Ability to explain intricate processes to patients and families empathetically.
• Organizational Skills: Strong attention to detail for managing multiple applications and deadlines.
• Compassion & Patience: Commitment to helping underserved populations.
• Problem-Solving: Resourcefulness in resolving obstacles related to coverage and financial aid.

What We Offer

• Competitive Salary: Based on experience and qualifications.
• Comprehensive Benefits:
• Health, Dental, and Vision Insurance
• 401(k) with Company Matching
• Paid Time Off (PTO), Holidays, and Sick Leave
• Flexible Spending Account, Life Insurance, and Employee Assistance Program
• Opportunities for Professional Growth and Development
• On-Site Role: Located in Greenfield, IN, offering direct collaboration with colleagues and the community.

Schedule

• Monday to Friday, standard 8-hour shifts (daytime hours).
• Regular, on-site attendance is essential for face-to-face patient interactions and collaboration with team members.

Work Environment & Physical Demands

• Healthcare Setting: Work is performed on-site in a clinic or hospital environment, requiring frequent interaction with patients, staff, and external agencies.
• Moderate Noise Level: Typical of a busy healthcare or office setting.
• Physical Requirements:
• Ability to sit, stand, and walk for extended periods.
• Manual dexterity for computer tasks and document handling.
• Reasonable accommodations will be provided to enable individuals with disabilities to perform essential functions.

Join Our Team

If you're committed to making a tangible difference in the lives of patients by helping them secure the financial assistance they need, we invite you to apply for the Eligibility Specialist – Patient Assistance Programs position at Healthcare Claims Management (HCM). Take this opportunity to be a vital part of our mission to improve access to care for underserved populations.