Hospital Eligibility Worker 2903, 03/2009 - Current
Jones Lange Lasalle Inc. – Mill Valley, CA, I perform eligibility, clerical, and administrative duties. Provide customer service to the general public. Interview patients, their relatives and other sources to obtain financial and demographic information, to determine eligibility for coverage of medical care under various federal, state, or county programs to secure a maximum reimbursement. I preform insurance verifications, secure authorizations, transfer agreements, admitting and registration duties for clinical and hospital services. Initiate referrals for acute care patients in addition to patients in skilled nursing facilities. Coordinate patient transfers between ZSFGH medical staff and other medical facilities. Explain eligibility programs, qualification standards, policy and procedures and assist patients in the completion of applications forms and reports as necessary. Review and evaluate applications for completeness and accuracy. Prepare records related to patient eligibility information and financial assistance receive. Update demographics and submit required reports. Corroborate statements information received from applicants through the use of telephone, written verification, and or several databases; in addition , I investigate and resolve patient questions and concerns regarding clinic and hospital bills. Review cases with the supervisor in assessing the quality of the payment source and medical facilities. I am the liaison with the sessions of outside providers and transferring facilities. Explain eligibility programs, policy and procedures to patients. Assist patients in the completion of applications forms and reports as necessary. Prepare records related to patient eligibility information and financial assistance received. Update demographics submit required reports investigate statements and information received from the applicants through the use of telephone or written verification. Furthermore, I investigate and resolve patient questions and concerns regarding clinic and hospital bills. Review cases with the supervisor in assessing the quality of the payment source determination process and procedure. I compose and compare correspondence to patients references and state agencies gathering statistical data and preparing reports. I am a Power User (Administrator Controller) for department's insurance verification websites. I participate in special projects, studies, work assignments, committees; in addition, to other duties as assigned. Lastly, I have the ability and willingness to effectively communicate orally or written with individuals from diverse social and economic and cultural backgrounds.