This document outlines the responsibilities and duties, for the Lead Eligibility Patient Advocate Liaison (LEPAL) / Eligibility Screener Team Lead Position. To maximize assistant and support, the position must be a full-time bilingual staff that speaks, reads, and writes Spanish fluently. This position will also serve as a regular Eligibility Patient Advocate Liaison (EPAL) for Southern California. Working days can vary depending on staff availability, however this specific position will be on-site with availability to travel to other hospital sites in the region as needed.
Compensation Range: $22 – $24/hr + Quarterly Bonus Eligible
Reports and Meetings:
The LEPAL, will review and complete all functions for the Daily New Business and Cancel Report as assigned
Review and complete the Weekly Complex Account (High Dollar) report as assigned
Will attend the Weekly Complex Account meeting every Tuesday and Thursday as assigned
Will attend the Huddles at various facilities as needed.
Will assist supervisor with accounts in a 1200, 1300 and 1400 dispositions.
Operations
Will assist staff when running the floor
Will review and scan all approvals
Will Assure that scanning is completed at all facilities
Will assist supervisor with staff development/training
Will assist hospital management/case management with account inquiries to bring resolution
Will address daily operational issues with staff
Will report concerns, deficiencies, and staffing issues to management.
Provide Routine Audits of staff to provide feedback to supervisor
Other duties related to accounts and client inquires
Follow up on CIN numbers as needed
Essential Duties & Responsibilities
Field questions from Patient Advocacy Liaison Team regarding work responsibilities and concerns
Assist in workflow distribution and delegate work responsibilities as needed
Screen patients and/ or patient representatives to determine potential eligibility for third party resources
Explain to patients and other entities the eligibility requirements, application process, and verification requirements for applicable programs
Facilitate the application process when appropriate for the patient by assisting the patient in the completing of the application, scheduling appointment interviews, and obtaining required verification
Maintain a professional relationship with the patient and governmental agencies to ensure cooperation and compliance
Document pertinent patient information in the appropriate systems dictated by the health care facility and the company
Document account activity as required by company policies and procedures in order to support account dispositions
Determine potential eligibility for health care coverage in accordance to state/ federal/ and local policies and procedures and pertinent legislation.
Monitor patient accounts to ensure appropriate processing timeframes are met.
Maintain confidentiality regarding patient’s health records and the company’s business practices
Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties
Perform other duties as assigned by management
Requirements
2 years of eligibility screening experience required.
2 years of medical customer service and/ or supervisory experience required. 3-4 years of medical customer service and/or supervisory experience preferred.
Ability to maintain the highest level of confidentiality.
Ability to lead, direct, and motivate others.
Ability to prioritize and work in a multi-tasked environment.
Ability to adapt to a flexible schedule.
Proficient personal computer skills, including Microsoft Office.
Excellent interpersonal, written, and oral communication skills.
Ability to work in a team fostered environment.
GetixHealth is an Equal Opportunity and E-Verify Employer
Experience
Required
2 year(s): Supervisory Experience
2 year(s): Medical Customer Services
2 year(s): Eligibility Screening
Education
Required
High School or better
Preferred
Associates or better
Behaviors
Required
Team Player: Works well as a member of a group
Leader: Inspires teammates to follow them
Functional Expert: Considered a thought leader on a subject
Enthusiastic: Shows intense and eager enjoyment and interest
Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
Motivations
Required
Self-Starter: Inspired to perform without outside help
Goal Completion: Inspired to perform well by the completion of tasks
Flexibility: Inspired to perform well when granted the ability to set your own schedule and goals
Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization