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Disability Specialist
Summary
Title:Disability Specialist
ID:1114
Department:Eligibility
Location :Bloomfield, NJ
Date Posted:10/08/2012
Description
JOB SUMMARY:  The Disability Specialist is responsible for determining if hospital patients meet the qualification requirements for State and Federal Disability Programs.  The Eligibility Specialist not only acts as an advocate for the patient in all matters related to the disability process, but also serves as a liaison to other Team members and to client hospital and government agency staff in a collaborative effort to facilitate eligibility for disability insurance coverage and/or income benefits.

 

Primary / Essential Functions:

The Primary/ essential job duties may not be exhaustive.

  • Provides superior customer service and maintains a professional image
  • Understands and meets the client’s needs, internal procedures and goals
  • Produces results that exceed expectations
  • Communicates effectively with multiple constituencies within the facility
  • Establishes and maintains strong working relationships

Application Process & Determining Eligibility

  • Review hospital referrals and screen for potential eligibility based on patient historical information
  • Contact patient or their representative ASAP to validate if eligibility criteria exist, and if so, acquire all necessary releases, signatures, documents (including the birth certificate), medical evidence, etc.
  • Consult as necessary with health care professionals involved in the patient’s care
  • Complete the full application and submit it with any acquired documentation in a timely manner to the appropriate agency
  • Advise the applicant of meeting all additional required documentation needs, keeping scheduled appointments and time frames for compliance and reinforce the advocacy role of the Disability Specialist.
  • Thoroughly enter all actions taken in the hospital account and in the internal data base/system

Follow-up & Monitoring

  • Maintain structured and timely contact with the applicant and responsible government agency, by phone whenever possible
  • Assist the applicant with meeting appointment dates and times and arrange transportation if warranted
  • Conduct home visits as needed to acquire documentation
  • In cases of an unfavorable determination, will file an appeal and possible second denial request for a Hearing before an administrative law judge and represent the claimant throughout that process
  • As per established protocols, inform the client in a timely manner of all approvals and denials of coverage
  • Thoroughly enter all actions taken in the hospital account and in the internal data base/system

Policy and Compliance

  • Participate in and complete all necessary job related in service training and continuing education opportunities in order to maintain a leading-edge knowledge
  •  Adhere to HIPAA rules of compliance
  • Understand, refer to, and comply with governmental policy related to program requirements for applicants

Professional Accountability

  • Communicates in a positive, effective and caring manner
  • Works efficiently, while being timely, thorough, accurate and complete
  • Protects the resources and information of our company, the applicant and our client
  • Adapts to change and challenges in a positive manner
  • Demonstrates competency in all assigned tasks
  •  Understands and implements best practices

 

  

Physical / Mental Demands, Environment:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions, recognizing that Adreima must work within the limitations established by the client when working on-site.

 

  • Must be able to use hands to finger, handle or feel, sit, stand, walk, lift up to 20 pounds, stoop, clean, bend, and reach with hands and arms.
  • Must communicate clearly in English.  Requires the ability to speak, read, write, see, and hear to perform essential duties of the job.
  • Effective and positive human relations skills are required, including confidentiality, in order to appropriately interface with staff, patients and their families.
  • Must be able to perform multiple tasks and detailed work, problem solve, reason, and perform basic mathematical calculations.

 

Equipment Used:

Telephone; FAX machine, calculator/adding machine, computer, monitor, printer, hardware and software packages, computer peripheral equipment i.e. mouse and keyboard; and Microsoft software (includes Excel).

 

Minimum Qualifications:

  • Bilingual Spanish to English preferred
  • Bachelor’s Degree in related field or combination of education and experience
  • Requires 3 to 5 years of related experience.
  • Experience in hospital business office and/or Medicaid casework is highly desirable.
  • Knowledge of Government eligibility program requirements is highly desirable.
  • Excellent communication skills, both verbal and written, with the ability understand users’ questions and effectively disseminate technical information is essential.                           
  • Basic knowledge of medical terminology and coding
  • Computer data entry or word processing skills and ability to operate routine office equipment are required.
  • Working knowledge of computer programs, i.e., Microsoft Excel®.
  • Must be able to type at least 30 wpm.
  •  Needs to have a valid driver’s license
  • Proof of Auto insurance coverage 

 

This opening is closed and is no longer accepting applications
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