Insurance Discovery Specialist

Description

• Responsible for screening patients to identify potential insurance eligibility.
• Conduct screening and/or research to identify and/or engage Patients who are eligible or potentially eligible for coverage through Medicaid, Medicare, other health insurance, or other medical assistance funding programs.
• Submit to the client information obtained on accounts found to have existing health insurance coverage.
• Meet in person/at bedside or virtually with Patient and/or VA staff to prepare necessary paperwork to apply for potential coverage
• Assist Patient in completing necessary paperwork to apply for potential coverage.
• Assist Patient in gathering required documents to support application for coverage.
• Submit completed applications to Social Worker
• Track contact with all Patients to determine if screening was in person or virtual, indicate program the Patient may be eligible for, and provide a date in which application was submitted to Social worker.
• Ensure found insurance coverage is provided to the client within one business day.
• Provide potentially eligible coverage plans within two business days from receipt of findings.
• Provide weekly updates on application status for uninsured and underinsured Patients.
• Provide the necessary fieldwork, administrative work, and any other assistance required to assist Patient in applying for Medicaid or other medical assistance funding.
• Assist with preparation of medical assistance applications necessary to discharge patients to a long-term care setting
• For Patients with no secondary coverage, assist the patient with completing an application for Medicaid secondary benefits, schedule interviews and gather supporting documentation.
• If state Medicaid rules require submission of an application to SSA as a condition to Medicaid approval, assist the Patient with the SSI/SSDI process, including all appeals.

Requirements

• Proficient in all Microsoft Office applications.
• Knowledge of health insurance payers and patient financial services preferred.
• Strong interpersonal and organizational skills.
• Excellent customer service skills.
• Able to work in a very fast-paced environment.
• Employees shall conduct in a business-like manner at all times while on VA premises.
• Attire: Employees shall wear an identifying badge with name, function, and a photograph of the employee. The employee will wear an appropriate and professional uniform. Any personnel performing contract services shall meet at all times the qualifications specified in this scope of work.
• Candidates shall have and be vaccinated prior to performance of work
• Health examinations including annual Tuberculosis (TB) skin test result, also known as PPD;
• Either received the Hepatitis B vaccine series, or is immune as a result of acquired infection, or have been offered and refused the vaccinations;
• Received measles-mumps-rubella (MMR) vaccine. Combined vaccine (MMR) is the vaccine of choice if individuals are likely to be susceptible to more than one of the three diseases and is required for all persons born after 1956;
• A negative PPD within the last (6) months, or if a known reactor, a negative chest X-ray within the past year;
• A history of varicella (chicken pox) or, if unknown, results of a varicella antibody test. If non-immune, must be vaccinated with varivax (chicken pox).