Insurance Eligibility Associate, Full Time, Day Shift-8Hr

Located in Templeton amongst the oak trees, Adventist Health Twin Cities has been serving northern San Luis Obispo County since 1977. Comprised of a 122-bed acute care facility, our team provides exceptional care in emergency medicine, orthopedics, obstetrics, digestive disorders, wound care, and various medical, surgical and outpatient services. Locals enjoy weekly farmers markets in downtown Templeton, farm-to-fork dining, beautiful landscapes for hiking and biking, and beach days just fifteen minutes away at Cambria and Morro Bay.

Job Summary:

Determines insurance eligibility and authorization. Obtains presumptive status for appropriate in-patients, ambulatory and procedural patients prior to date of service or as soon as reasonable after self-pay or uninsured status is identified. This position is represented by SEIU.

Job Requirements:

Education and Work Experience:

• High School Education/GED or equivalent: Preferred
• Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred
• Experience in health care, eligibility/verification processes and systems and experience working with Medicaid and uninsured patients: Preferred
• Experience in one-to-one counseling and coaching: Preferred
• Experience in health care insurance, billing, finance, patient access or other similar field: Preferred

Licenses/Certifications:

• Certified Healthcare Access Associate within one year of employment: Preferred

Essential Functions:

• Determines patient self-pay status and works closely with clinical departments and support programs to assist patients in understanding and meeting financial obligations. Develops working relationships with case management services, charity care program staff, billing staff and front end staff to ensure the quality processes and identify patient insurances that affect revenue and patient services.
• Helps patients acquire eligible health insurance through the State Health Benefit Exchange or through paper application processes, as appropriate. Provides education and assistance to individuals wishing to enroll in health coverage, advises on coverage options and assists in completing appropriate application process. Collaborates with case management services to help patients determine eligibility for applicable Medicaid products and services, including dual eligibility, long-term care and temporary assistance. Conducts outreach and education activities, as needed.
• Coaches, trains and supports staff about meeting eligibility verification and quality measures for front end processes. Collaborates with local social service departments. Serves as a knowledgeable resource for patients and others when obtaining resources, for appropriate medical service utilization and to help meet financial obligations.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.