Eligibility Representative III - Team Lead

Job Description

Job Description

DECO has an exciting career opportunity available as a Eligibility Rep - Team Lead. This position will be located in Melbourne, FL. The Full Time schedule for this role will be Monday through Friday, 8a - 5p.

JOB SCOPE

Lead Eligibility Representative will attempt to perform detailed in-house review and bedside interviews to determine if patient is a viable candidate for State, Federal, County, Medical or Disability Assistance, and assist with the application process for any Assistance type program. This assistance will include the necessary investigative, field, and administrative work needed to assist the patient in meeting eligibility requirements for any program if appropriate.

JOB RESPONSIBILITIES

• Assists the daily supervision of Eligibility staff performing patient-oriented tasks and follow up.
• Assists with work schedules to ensure adequate coverage for outbound patient outreach and follow-up.
• Assists in monitoring of work guidance and performance measures to meet goals for delivery of service.
• Provides assistance to the program manager in evaluating and assessing employee progress.
• Performs and submits basic audits as assigned to measure overall productivity and performance.
• Interact with patients, patient representatives and/or families in order to obtain or determine theeligibility of the patient for Federal or State assistance.
• Facilitates the application process when appropriate by assisting the patient in completing the application, scheduling appointment interviews and obtaining required verification.
• Documents pertinent patient information and account activity in the appropriate systems dictated by the health care facility and DECO.
• Determines potential eligibility for health care coverage in accordance to state/federal/local policies and procedures.
• Effectively requests and tracks field visits.
• Submits accurate and concise information to facilitate appropriate billing follow up.
• Consistently updates knowledge of multi- state/federal/local program policies and procedures.
• Monitors patient accounts to ensure appropriate processing timeframes are met.
• Maintains confidentiality regarding patient’s health records and DECO business practices.

JOB QUALIFICATIONS

• Some college and two years related experience and/or some combination of education, related experience and/or training
• Willingness to work as part of a management team, with some supervision experience or training.
• Advanced understanding of the Medical Assistance application process, including a basic understanding of various aspects of eligibility analysis and evaluation process.
• Knowledge of multiple state/federal/local program policies and procedures
• Proficient in Microsoft Office applications, including advanced Excel, charts, graphs, PowerPoint. Accurate typing/data entry at a minimum of 30WPM.
• Ability to communicate effectively in writing and verbally.
• Ability to establish and maintain cooperative working relationships with patients, third party resources, co- workers and management.
• Ability to follow complex instructions and procedures, paying close attention to details and to organize work in a systematic efficient fashion.
• Ability to adapt to a flexible schedule.

DECO is an Equal Opportunity Employer