Eligibility Specialist

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

UNC Health Nash, an affiliated member of the UNC Health system, invites passionate healthcare professionals to join our esteemed team. Governed locally, we proudly serve a diverse patient base, spanning Nash, Edgecombe, Halifax, Wilson Counties, and beyond. With a steadfast commitment to elevating community health through exceptional care, we prioritize excellence, compassion, and innovation, ensuring every individual receives the highest standard of support. Joining our team means becoming an integral part of our dedication to wellness, where we constantly strive to redefine excellence in healthcare through state-of-the-art facilities and pioneering programs. Join us in this transformative journey, where your contributions will make a lasting impact on our community's health and wellbeing.

Summary:
The Medicaid Eligibility Specialist coordinates and facilitates the Medicaid application process across multidisciplinary entities to obtain Medicaid eligibility for patients entitled to Medicaid for the purpose of attaining reimbursement for services provided by Nash Health Care Systems.

Responsibilities:
1.Advise and instruct patients on the procedures of applying for Medicaid and/or Social Security Disability benefits.
2.Follow-up with patient and County DSS to assure all pertinent information has been provided relevant to the applications and that applications are being processed within appropriate timeframes.
3.Analyzes patient's assets, income and potential for disability; explains the programs and advises patients of methods to reduce reserve in a timely manner based on knowledge of the Medicaid and Social Security regulations.
4.Evaluates denials and follow through with County DSS contacts and/or patient to determine basis of the denial; evaluate denial and follow through with requesting appeal.
5.Gathers appropriate documentation, prepares appeal summary and represents the patient at county and state hearings by providing convincing evidence for the purpose of reversing a negative decision with or without the patient's assistance.
6.Training and Development (includes meeting attendance).

Other information:
Education Requirements:
*Associate's degree in business. Years of experience may be substituted for degree. One year of experience for one year of education.
*Bachelor's degree in business, healthcare administration, accounting, finance or a related field is preferred.
License/Certification Requirements:
*None.
Professional Experience Requirements:
*Minimum of four (4) years of related experience in a social services or healthcare organization.

Legal Employer: Nash Hospitals

Entity: Nash UNC Health Care

Organization Unit: NGH Registration Discharge

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: NASH HC

Exempt From Overtime: Exempt: No

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.