Eligibility Specialist - Medicaid Eligibility
Company: UNC Health Care Systems
Location: Chapel Hill
Posted on: January 12, 2022
Become part of an inclusive organization with over 30,000 diverse
employees, whose mission is to improve the health and well-being of
the unique communities we serve.
Performs technical work in obtaining Medicaid/Social Security (SSI)
insurance coverage for indigent patients to expedite reimbursement
for medical services. Positions take the patient through the entire
Medicaid application process from application to award or denial.
Positions have authority to represent the Health Care System at
each of the four levels of appeals when applications are
1. Obtains detailed personal, financial and asset information to
determine if patient qualifies for one of ten Medicaid/SSI
programs. Completes or assists the patient with completion of
Medicaid application. Explains the programs and advises patients of
methods to become eligible by rearranging finances and assets.
Follows through with applicants to obtain accurate and complete
information within strict timeframes. Positions must have
substantive knowledge of various rules and regulations governing
the ten Medicaid programs. Interprets and applies frequent changes
in program regulations to expedite applications.
2. Reviews denials from Medicaid/SSI and researches denial
information with patients. Advocates for patient coverage with
local and state Medicaid offices to obtain reversal of initial
denial. Abstracts information, prepares appeals and represents UNC
Health Care System in appeal hearings at local, state (Division of
Medical Assistance), Office of Administrative Hearings, and state
court to present supportive evidence for patient?s denial
Associate's degree in an appropriate discipline (or equivalent
combination of education, training and experience).
No licensure or certification required.
Professional Experience Requirements:
If an Associate's degree: Two (2) years of experience in a social
services or healthcare organization.
If a High School diploma or GED: Four (4) years of experience in a
social services or healthcare organization.
Knowledge/Skills/and Abilities Requirements:
Analytical, Customer Service, Direct Patient/Family Interaction/
Hospital/Healthcare Experience, Interpersonal, Report Preparation,
Strong Written and Verbal Communication skills.
Entity: Shared Services
Organization Unit: Medicaid Eligibility
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: No
Keywords: UNC Health Care Systems, Chapel Hill , Eligibility Specialist - Medicaid Eligibility, Other , Chapel Hill, North Carolina
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