Insurance Discovery Specialist

Company: Shelby American, Inc.
Location: San Francisco
Posted on: April 1, 2025

Job Description:

Description

• Responsible for screening patients to identify potential insurance eligibility.
• Conduct screening and/or research to identify and/or engage Patients who are eligible or potentially eligible for coverage through Medicaid, Medicare, other health insurance, or other medical assistance funding programs.
• Submit to the client information obtained on accounts found to have existing health insurance coverage.
• Meet in person/at bedside or virtually with Patient and/or VA staff to prepare necessary paperwork to apply for potential coverage.
• Assist Patient in completing necessary paperwork to apply for potential coverage.
• Assist Patient in gathering required documents to support application for coverage.
• Submit completed applications to Social Worker.
• Track contact with all Patients to determine if screening was in person or virtual, indicate program the Patient may be eligible for, and provide a date in which application was submitted to Social Worker.
• Ensure found insurance coverage is provided to the client within one business day.
• Provide potentially eligible coverage plans within two business days from receipt of findings.
• Provide weekly updates on application status for uninsured and underinsured Patients.
• Provide the necessary fieldwork, administrative work, and any other assistance required to assist Patient in applying for Medicaid or other medical assistance funding.
• Assist with preparation of medical assistance applications necessary to discharge patients to a long-term care setting.
• For Patients with no secondary coverage, assist the patient with completing an application for Medicaid secondary benefits, schedule interviews and gather supporting documentation.
• If state Medicaid rules require submission of an application to SSA as a condition to Medicaid approval, assist the Patient with the SSI/SSDI process, including all appeals.Requirements
  • Proficient in all Microsoft Office applications.
  • Knowledge of health insurance payers and patient financial services preferred.
  • Strong interpersonal and organizational skills.
  • Excellent customer service skills.
  • Able to work in a very fast-paced environment.
  • Employees shall conduct themselves in a business-like manner at all times while on VA premises.
  • Attire: Employees shall wear an identifying badge with name, function, and a photograph of the employee. The employee will wear an appropriate and professional uniform.
  • Candidates shall have and be vaccinated prior to performance of work.
  • Health examinations including annual Tuberculosis (TB) skin test result, also known as PPD.
  • Either received the Hepatitis B vaccine series, or is immune as a result of acquired infection, or have been offered and refused the vaccinations.
  • Received measles-mumps-rubella (MMR) vaccine, required for all persons born after 1956.
  • A negative PPD within the last six (6) months, or if a known reactor, a negative chest X-ray within the past year.
  • A history of varicella (chicken pox) or, if unknown, results of a varicella antibody test. If non-immune, must be vaccinated with varivax (chicken pox).
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Keywords: Shelby American, Inc., San Francisco , Insurance Discovery Specialist, Other , San Francisco, California