Managed Care Advocate

For over 25 years, Revecore has been at the forefront of specialized claims management, helping healthcare providers recover meaningful revenue to enhance quality patient care in their communities. We're powered by people, driven by technology, and dedicated to our clients and employees. Our medical, dental, vision, and life insurance benefits are available from the first day of employment

Our Employee Resource Groups build community and foster a culture of belonging and inclusion

We offer career growth opportunities

We celebrate 12 paid holidays and generous paid time off

Location: (On-site) The Role: This position is primarily responsible for effectively assisting clients in an Acute-Care Hospital Setting in securing medical coverage by screening clients for eligibility and completing Medicaid applications with the clients. Assist uninsured and underinsured patients secure healthcare benefits by conducting screening applications on patient referrals received from the hospital. Effectively assist patients in securing medical coverage by screening referred patients and coordinating the application process through successful approval and invoicing. As an Eligibility Advocate, you will:

Documents Company database with action that was taken on the account/application in a timely manner. Effectively and accurately follows established work procedures and guidelines to be efficient in the Medicaid application processes. Includes application completion, collection of all documentation, including detailed case comments.

Attends any company and/or facility compliance training.

Complies with all company policies as well as state and federal regulations including, but not limited to attendance, performance, patient privacy, system security and safety.

Maintains knowledge of all State Medicaid and CHP+ policy information/guidelines/training.

Locates, understands, and interprets written information in a variety of formats including such documents such as manuals, reports, graphs, etc.

Uses own vehicle to travel to various locations for reasons including, but not limited to, outside training, facility coverage, home visits, and agency visits.

Uses reference material available on Company resource sites, state/county websites, and other web-based sites effectively and regularly.

Effectively uses computer systems to include but not limited to Company database system, and hospital system.

Effectively documents and demonstrates a performance standard of 85 consistently.

Assist with the entry of all referrals and account documentation.

Screenings are completed in the hospital, by phone, and occasionally in patient's home.

Complete and copy all relevant applications.

Gather all required verification documents and submit them to appropriate agencies by the deadline for processing.

Follow up with agencies to ensure submitted applications are processed in a timely manner.

Assist in appealing denied applications.

Update all hospital and company systems with current activity and notes.

Submit verified billing numbers to facilities.

Provide hospital with all requested information in a timely manner.

Complete assigned invoicing functions including capturing claim bill dates, payment dates and payment amounts, from hospital system and assigning appropriate invoice fee types.

Comply with all state and federal regulations and company policies that include but not limited to patient privacy (HIPAA).

High school diploma or general education degree (GED);

One to three years of related experience such as advocacy and customer service and/or training; Case management experience and working knowledge of State and Federal programs such as Medicaid and Social Security Disability, is a plus,

Experience with hospital billing systems (Meditech, EPIC, Allscripts, MS4, etc.) Past advocacy experience or experience with helping others through enrollment processes is a positive.

Must be comfortable working directly with patients in an inpatient hospital room environment, to include behavioral health patients.

Ability to quickly and accurately capture heavy documentation requirements in both the company and hospital computer systems

MS Office proficiency

Strong typing and documentation skills

Exemplary customer service

Bilingual English / Spanish is required for some positions

Revecore is an equal opportunity employer that does not discriminate based on race, color, religion, sex or gender, gender identity or expression, sexual orientation, national origin, age, disability status, veteran status, genetic information, or any other legally protected status. We believe that a diverse workforce fosters innovation and creativity, enriches our culture, and enables us to better serve the needs of our clients and communities.