Job Description
Assists patients in identifying and obtaining alternate health care resources, including Medicare, Medicaid, VA, Tribal, and other third-party programs.
Conducts patient interviews to gather information for eligibility determinations and enrollment.
Assists with completing applications, verifying eligibility, and maintaining enrollment records.
Provides information regarding benefits, coverage, program requirements, and available resources.
Coordinates with patients, families, healthcare staff, and external agencies to obtain required information and facilitate referrals.
Follows up on pending applications, enrollments, and claims to support timely processing.
Assists in resolving eligibility, coverage, and reimbursement issues in accordance with established policies and procedures.
Maintains confidential patient information and records in compliance with Privacy Act and HIPAA requirements.
Utilizes automated systems to document, track, and report eligibility and enrollment activities.
Supports patient access to healthcare services through effective customer service and application of alternate resource program requirements.