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Lead Eligibility Representative

Company Name:
DECO Recovery Management
JOB MISSION:
The Lead Eligibility Representative is that member of the Operations Team who appropriately interacts/interviews referrals from the facility in a professional and business like manner. Functions as the interface between Deco Clients and the State, Federal, County, Medical or Disability agencies to which we are applying. Assists in the daily supervision of Eligibility staff performing patient-oriented tasks and follow up. Assists in developing, and reviewing employees and their performance. Assists in the development and monitoring of work guidance and performance measures to meet goals for delivery of service. Able to interact with senior management, and client administration with an advanced level of professional courtesy and advanced customer service skills.
Job Scope
Lead Eligibility Representative will attempt to perform detailed in-house review and bedside interviews to determine if patient is a viable candidate for State, Federal, County, Medical or Disability Assistance, and if so to assist the patient/guarantor with the application process for any Assistance type program. This assistance will include the necessary investigative, field, and administrative work needed to assist the patient in meeting eligibility requirements for Disability, Medicaid or other applicable County, Federal or State programs if appropriate.
Job Qualifications
Some college a nation of education, related experience and/or training
Willingness to work as part of a management team, with some supervision experience or training.
Advanced understanding of the Medical Assistance application process, including a basic understanding of various aspects of eligibility analysis and evaluation process.
Knowledge of multiple state/federal/local program policies and procedures
Ability to use a PC effectively including various database programs, Accurate typing/data entry at a minimum of 30 wpm
Proficient in Microsoft Office applications, including advanced Excel, charts, graphs, power point
Ability to communicate effectively in writing and verbally.
Skill in reading documents written in Standard English text such as administrative policy and procedures manuals.
Ability to establish and maintain cooperative working relationships with patients, third party resources, co- workers and management.
Able to follow complex instructions and procedures, paying close attention to details and to organize work in a systematic and efficient fashion.
Skill in organizing and setting priorities, which accurately reflect the relative importance of job responsibilities.
Skill in speaking clearly and distinctly using appropriate vocabulary and grammar to obtain the information necessary to execute the business of DECO.
Ability to adapt to a flexible schedule
Availability of reliable transportation for use in Field Visits.



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