Northwell Health Medicaid Investigator - PER DIEM in New Hyde Park, New York

Req Number 001RZY

Job Category Billing Clerical

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.

Responsibilities Include:

  • 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.

Qualifications

  • 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.

  • Performs related duties, as required.