Diversified Healthcare Resources, Inc.
Our primary goal is to provide patient advocacy services to hospital patients by screening, identifying and enrolling them for all potential eligibility programs in an effort to secure medical coverage.
With more than 20 years of experience, we have been providing patient advocacy services to determine a patients eligibility for government programs and getting hospitals paid for patient care. Our technical and experienced team implemented and monitored various eligibility and enrollment programs that measure the performance and integrity of various eligibility modules in more than 220 public and private hospitals and health systems. Through this experience, we have learned what works and what doesnt for the hospitals and for the patients.
Bilingual Intake Patient Advocate of Enrollment Services - Oakland, CA
We are seeking highly motivated Patient advocates that will join us in our Mission to provide the best resources to our patient and hospitals, with regard to all aspects of Medi-Cal and government programs, and to improve our relationships with the highest level of compassion and integrity. We believe it is our responsibility to think outside the box, always looking for alternatives to optimize our resources. If you are organized and want to make a difference in our patients lives by providing the best service possible, always assuring the utmost quality and possess excellent time management and communication skills. We believe in providing the means to make a difference and to achieve endless possibilities.
- Interview and screen patients at bedside or by telephone.
- Evaluate patients within established guidelines to assist in identifying federal, state and county programs that patients may qualify.
- Obtain current demographics and inquire about current circumstances, such as last date of employment, employer information and income.
- Initiate and complete the application process for benefits by assisting applicants with the completion of all the necessary paperwork and working aggressively to obtain all the pending verifications and file at the corresponding county office.
- Ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately and notifies appropriated hospital staff.
- Compile records and assess information to determine eligibility status, including number of people in applicants household.
- Document and update efforts in our database to ensure our hospitals have current updates on the outcome and successful completion of our cases and approvals.
- Focus on individual performance, Key Performance Indicators (KPI) and expediting approvals by gathering and completing forms before the applicant is discharged.
- Expedite approvals by assisting with the proactive gathering of all medical information forms
- Perform clerical tasks, such as typing and filing, and have knowledge of government regulations
- Work with county/state/federal agency workers and representatives to create a positive working relationship.
- Request medical records, home visits, field visits and any necessary items to expedite cases.
- Work with colleagues to ensure timeliness of tasks and support them with follow up communications and cover other advocates as needed.
- Complete comprehensive training programs as required.
- Employees are expected to protect the privacy of all PHI in accordance to privacy policies and procedures and as required by state and federal law including but not limited to the HIPAA Security and Privacy Rules.
- Interact with all levels of hospital and county staff and knowledge of government regulations.
- Work with county eligibility workers and county offices to create a positive working relationship.
- Update case managers, social workers, financial counselors on urgent and critical in-house patients by acting as the liaison between the hospital and office.
- Work may be routine, requiring to sit or stand for prolong periods at a time, working in front of a computer screen and for carrying up to 10 lbs. (i.e., DHR intake bag, rolling bag including, but not limited to, applications, forms, etc.).
- Work may be occasionally stressful. Must be able to deal with difficult applicants or a large volume of applicants in one day, and maintain a caseload of 15 accounts which includes 4-5 new referrals per day and be able to work off of intake reports on a daily basis.
- DHR/hospital documentation daily of work efforts and updating of KPIs.
- Some travelling is required to attempt home visits, field visits to county offices, and may be necessary to cover other hospitals.
The ideal candidate will possess a positive, compassionate, caring attitude to ensure dignity for the patients along with strong organizational skills. We believe, above all else, we should provide the best service possible, always assuring the utmost quality. We will train the right individual on the technical aspects of the government programs including enrollment and processing but we do require the following skills, experience and attributes:
- Bilingual in English/Spanish
- Organizational Skills, Analytical Skills, Time Management, Ability to Work under Pressure, Decision Making and Problem Solving Skills.
- Strong analytical skills, problem solving. The ability to act and decide accordingly and to collect, analyze and research complex or diverse information.
- Exceptional customer service and communication skills.
- Ability to plan organize and exercise sound judgment
- Ability to challenge and debate issues of importance to the organization to Leads and Directors
- Strong knowledge of MS Office Applications and Internet usage.
- College degree preferred or high school diploma or equivalent
We offer competitive compensation based on experience. Excellent benefits package including paid time off, medical, dental and vision benefits, 401(k) plan and other perks. Training and development resources include virtual learning centers and online accredited courses that allow future growth opportunities within the Company. Mileage reimbursement. In addition, we strive to provide and maintain a positive work environment where each employee feels encouraged to contribute to our processes, decisions, planning and culture.
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