Responsible for assessing patient’s eligibility for all available financial programs, ability to pay and available payment alternatives. Makes financial arrangements for patients without insurance coverage; assists patients in obtaining financial sponsorship from outside agencies and charitable programs when financial need is indicated. Researches and collects at point of service on bad debt accounts. Collects patient portions and deposits from patients at the point of service. Serves as a patient representative and advocate working with medical assistance offices and/or third parties in completing appropriate payment and application forms. Pursues acceptance of eligibility and provides recommendations in order to maximize opportunities for reimbursement while minimizing the financial risk to the organization.
Completes frequent face to face patient interactions completing intake application and all required forms. Obtains all documents for verification as defined by the standards. Determines eligibility for various Ryan White funded services (Part B and C) including HIV medical case management and ADAP, AIDS Drug Assistance Program, as well as other community resources. Schedules medical case management screening appointment.
Obtains proper HIV status documentation and residency information.
Performs the 6 month eligibility review and obtains necessary documents as defined by the standards,
Complete required data entry into required patient database.
Demonstrates and applies a thorough knowledge of benefit programs such as Medicaid, SSI/SSDI, Medicare, TANF, SNAP, Auxiliary Grant, etc. Coordinates with Carilion’s Financial Assistance Program, MedKey, and hospital payment plan eligibility rules, regulations and procedures in order to assure accurate processing of accounts for billing and reimbursement when patient requires additional assistance.
Maintains current information on all frequently used community resources, as needed.
Collaborates with the team to ensure patient timely access to care and access to appropriate resources.
What We Require
Education: Four year degree in Social Sciences or related field preferred.
Experience: Minimum of two years benefits eligibility experience with State Social Services system or experience in a medical advocacy program or closely related experience required.
Other: Demonstrated human relation and effective communication skills, excellent organizational skills and multitasking required. Computer skills essential. Must have reliable transportation.
About Carilion
This is Carilion Clinic ...
An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.
Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.
Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.