Eligibility Specialist - PRN, As Needed

Job Description

Maintain up-to-date knowledge of regulations involving government sponsored programs, hospital charity care policies, and other financial assistance programs, including eligibility criteria and application procedures.

Assess patients' financial situations to determine eligibility for government sponsored programs, charity care, or other financial assistance programs through interviews, document reviews, and verification processes.

Guide patients through the completion and submission of applications for government sponsored programs, hospital charity care, and other relevant programs, ensuring all required documentation is accurate and complete.

Act as a liaison between patients and program administrators, advocating for patients to ensure timely processing of applications and resolution of issues.

Maintain accurate and confidential records of patient interactions, eligibility assessments, and application statuses in compliance with hospital policies and applicable regulations.

Educate patients and families about available financial assistance options, explaining complex program details in a clear and empathetic manner.

Work closely with hospital billing, social work, and case management teams to coordinate patient care and financial support services.

Ensure all activities adhere to federal, state, and hospital regulations, including HIPAA, regarding patient privacy and financial assistance processes.

Verify and correctly assign insurance coverages based on eligibility responses.


Perform all other duties as assigned.

Work Schedule: PRN, As Needed

Qualifications/Training:

1. Minimum of two (2) years of experience in healthcare, social services, insurance, or government payor programs preferably in patient financial services or case management.
2. Strong understanding of government sponsored programs, insurance, and charity care programs or ability to quickly learn program requirements.
3. Excellent communication and interpersonal skills to interact with diverse patient populations.
4. Detail-oriented with strong organizational skills to manage multiple applications and deadlines.
5. Proficiency in Microsoft Office and electronic health record (EHR) systems.
6. Ability to handle sensitive information with confidentiality and professionalism.
7. Compassionate, patient-focused, and ability to work effectively under pressure in a fast-paced hospital environment.

Licenses/Certifications/Registrations/Education

1. High school diploma or equivalent required.
2. Associate's or bachelor's degree in healthcare administration, social work, or related field preferred.

About Us

Founded in 1906, McLeod Health is a locally owned and managed, not for profit organization supported by the strength of more than 900 members on its medical staff and more than 2,900 licensed nurses. McLeod Health is also composed of approximately 15,000 team members and more than 90 physician practices throughout its 18-county service area. With seven hospitals, McLeod Health operates three Health and Fitness Centers, a Sports Medicine and Outpatient Rehabilitation Center, Hospice and Home Health Services. The system currently has 988 licensed beds, including Hospice and Behavioral Health. The hospitals within McLeod Health include: McLeod Regional Medical Center, McLeod Health Dillon, McLeod Health Loris, McLeod Health Seacoast, McLeod Health Cheraw, McLeod Health Clarendon and McLeod Behavioral Health.

About the Team

If you would enjoy working in a dynamic environment and are looking for an opportunity to become part of a stellar team of professionals, we invite you to apply online today. We are an equal opportunity employer.