At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. MEDICAID ELIGIBILITY ANALYST Duke University Health System - Patient Revenue Management Office PRMO seeks to hire a Medicaid Eligibility Analyst who will embrace our mission of Advancing Health Together. This is a hybrid remote position working between 1-4 days a week remotely depending on the needs of the department Work Hours: Monday - Friday 8:00am - 5:00pm Bilingual strongly preferred General Description of the Job Class Coordinate and facilitate the Medicaid application process across multidisciplinary entities to obtain Medicaid eligibility for patients entitled to Medicaid for the purpose of attaining reimbursement for services provided by Duke University Health System. Duties and Responsibilities of this Level Conduct thorough, in-depth interviews and evaluate patient’s case for potential eligibility for Medical Assistance Programs and any applicable Purchase of Medical Care programs. Analysis of patient’s assets, income, clinical history, and dependent responsibilities, must be conducted in a precise manner based on knowledge and interpretation of the federal regulations and Social Security Administration guidelines. Assess patient’s continuing care needs and determine correct program and certification period to minimize patient deductible and maximize entity reimbursement. Communicate and advise patients on complex financial concepts and procedures of applying for Medicaid. In some cases, may act as the authorized patient’s representative for the purpose of initiating an application for benefits and for conducting any and all activities associated with determination of eligibility of benefits, including the initiation and conduct of administrative and /or judicial appeals. There is legal liability involved for the Medicaid Eligibility Analyst, as they are responsible to the county/state for the accuracy of information and actions taken on behalf of the patient. The Medicaid Eligibility Analyst has the ability to act for the individual and exercise the individual’s rights. Coordinate and facilitate the completion of the Medicaid application. Gather and provide necessary verifications to establish Medicaid eligibility via direct contact with patient and/or patient’s family, employer, financial institution, vital statistics and other collaterals to the County Department of Social Services Income Maintenance Caseworker in the county o
