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Reporting to the Eligibility Manager, the Caseworker for Medicaid and Disability will complete tasks related to securing eligible healthcare funding for patients through programs such as Medicaid, Social Security, County Indigent, and other available funding sources. This role involves helping patients and their families complete necessary forms, applications, and paperwork. Caseworkers will screen patient eligibility in-person, bedside and via phone, determining their qualification for various Federal, State, and County programs, including Medicaid, Disability, and ACA Marketplace Insurance. The schedule is Sunday-Thursday 8:00am-4:30pm.
Responsibilities:
Complete approximately 5-8 new self-pay screenings bedside daily
Collect all required documentation and review patient information to determine patient’s eligibility
Perform all discharge screenings by phone
Provide program options that HealthFund Solutions can assist in applying for the patient
File all applications that the patient might be eligible for within 24 hours
Follow-up on all pending documents for each file
Follow-up on previously filed applications until approved
Review all documents before sending to Federal/State/or County agencies for accuracy and completeness
Submit required documentation
Immediately after screening the patient, IF they meet sponsorship qualifications send referrals to Sponsorship
Review application denials with management
Maintain accurate files & notes on actions taken to be recorded in hospital software and HealthFund Solutions database
Communicate with patients and hospital staff (written and verbal)
Maintain and update database as new information becomes available
Manage large caseload to completion
Develop and retain a professional relationship with HFS staff and hospital staff
Will require working evenings, weekends, and some holidays
Other duties assigned by Management
Qualifications & Skills:
Highschool required
Associate’s degree preferred
Thorough knowledge and understanding of Florida Medicaid eligibility criteria
Full Cycle Florida Medicaid application experience preferred
Disability application experience preferred both Medicaid and Social Security
Ability to maintain and respect confidentiality and HIPAA guidelines
Highly effective in working objectively with a diverse group of people and must demonstrate communication, organizational, administrative and time managers ability to read and comprehend simple instructions
Ability to self-direct work
Effective stress coping skills
Bi-lingual with Spanish preferred
Ability to communicate clearly and concisely is required
Excellent verbal and written communication skills
May require working evenings, weekends, and some holidays
Experience with Florida Family Medicaid, Medicaid Disability, Social Security Disability and filing DCF applications preferred
Florida DCF experience a plus
NOTE: This job description is not intended to be all-inclusive. Employees may perform other duties as required to meet the ongoing needs of the organization. All candidates must successfully pass a national background check and a 12-panel drug screening. HealthFund Solutions is a drug-free workplace.
We are an equal opportunity employer. All qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status
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