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Healthcare Financial, Inc.

 Location: Holyoke, MA 01040 Document ID: AA173-2SMH Posted on: 2016-04-2704/27/2016 Job Type: Regular

Job Schedule:Part-time
Minimum Education: Bachelors2016-05-27
 

Patient Enrollment Specialist

Job Title: Patient Enrollment Specialist
Department: Operations
Reports to: Hospital Operations Manager

Location: Holyoke, MA

JOB SUMMARY

The primary goal of the Patient Enrollment Specialist (PES) is to work in close collaboration with their assigned patients and hospitals to determine eligibility for MassHealth, Connector Care, or Health Safety Net programs.  The PES will also assist in the completion of the appropriate applications, articulate the stages of the application lifecycle, and serve as a point-of-contact for both the patient and the hospital. Responsibilities include, and are not limited to:

 

ESSENTIAL FUNCTIONS & RESPONSIBILITIES
  • Screen and determine program eligibility for patients in hospitals which can include inpatient, emergency, and outpatient settings.  May also screen patients by phone, at their home, or in other community-based settings after discharge.
  • Educates the patient and his/her family on the various coverage types and what happens during all stages the application lifecycle. 
  • Manages and prioritizes referrals appropriately.
  • Timely documents the company’s database with information relevant to the application process.  This includes all attempts to complete an application along with assessments made, verifications obtained, and attempts to move an application to a decision.
  • Updates hospital database with information specific to the screening outcome.  This may include adding indicators of a pending application or coverage.
  • Completes necessary applications and forms within the timelines established.
  • Maintains patient confidentiality at all times.  This includes the safeguarding of data collected with respect to both HIPPA and PPI.
  • Understands the need to be productive at all times.
  • Performs customer-service oriented tasks as needed.  This may include the need to assisting or direct patients to other areas of the hospital, provide hospital-based Case Managers information to help facilitate discharge, or provide updates on the status of an application.
  • May call state agencies to assist in expediting the application or to assist in health plan enrollment where appropriate.
  • Travels to hospitals and other client sites throughout the day as assigned.
  •  Demonstrates receptive, empathic and sensitive attitudes.
  • ​ Participates in committees and projects as assigned by the Hospital Operations Manager. 
  • Required home office set-up to facilitate outreach opportunities and database updating.
  • ​Other duties may be assigned.
 

 

MINIMUM requirements
  • Bachelor's degree in related field, required.
  • Medicaid and/or Social Security knowledge and experience is a plus.
  • Bilingual (Spanish/Portuguese), preferred.
  • Valid driver’s license, access to reliable motor vehicle, and auto insurance. 
  • Willingness to travel 10 – 15% is required; all travel is local.
  • Excellent communication skills and the ability to quickly engage in conversation required.
  • Ability to work independently with minimal supervision. 
  • Strong analytical and decision-making skills. 
  • Self-motivated, responsible, and accountable. 
  • Identifies own learning needs and seeks appropriate assistance.
  • Computer skills including web-based database updating and Microsoft Office. 
  • Ability to work well within a fast-paced, team-oriented environment.
  • Work Schedule: Part-Time hours (10-25 hrs./week) with potential variable shifts between 8:00 AM and 6:00 PM from Monday to Sunday

WORKING CONDITIONS / WORK ENVIRONMENT

Primarily home office with occasional work at client site with moderate noise level associated with open office work environment.

Physical Demands:

While performing the duties of this Job, the employee is regularly required to talk or hear; stand, walk, sit, use hands to finger, handle or feel objects, and reach with hands and arms. The employee occasionally will lift and/or move up to 15 pounds.  Also, employee is required to travel to and from different work sites throughout the day, so employee may be sitting for long periods of time.  Travel time will be at least 10% of the time.
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