Medicaid Eligibility Representative
Dallas, TX Revenue Integrity
Job Type
Full-time, Part-time
Description

  

  • Screen patients for Medicaid and other government program eligibility at bedside, registration, or via telephone.
  • Complete and submit Medicaid applications accurately and timely in accordance with state and federal guidelines.
  • Obtain and verify required documentation including income, residency, citizenship, disability, and household information.
  • Educate patients and families on Medicaid benefits, eligibility requirements, and application processes.
  • Act as liaison between patients, hospital departments, and state Medicaid offices.
  • Track application status, follow up on pending cases, and resolve denials or requests for additional information.
  • Document all eligibility activities in the hospital’s electronic health record (EHR) and eligibility systems.
  • Collaborate with Patient Access, Case Management, Social Services, and Billing departments to ensure continuity of coverage.
  • Ensure compliance with HIPAA, CMS regulations, and hospital policies.
  • Meet productivity and quality benchmarks related to application approvals and turnaround times.
  • Assist with audits, reporting, and performance improvement initiatives related to Medicaid eligibility.
  • Maintain up-to-date knowledge of Medicaid policy changes and eligibility criteria.
Requirements

  

  • Minimum of 2-3 years' experience in Medicaid eligibility, patient access, financial counseling, or healthcare      registration
  • Knowledge of Medicaid eligibility rules and application processes
  • Proficiency with electronic eligibility systems and EHR platforms
  • Strong attention to detail and documentation accuracy
  • Excellent verbal and written communication skills
  • Ability to handle sensitive financial and personal information with discretion
  • Strong customer service and patient advocacy skills
  • Associate’s degree or higher in healthcare administration, social services, or related field
  • Hospital or acute care experience
  • Experience with state Medicaid portals and verification tools
  • Bilingual (English/Spanish) preferred
  • Familiarity with CMS, SSI, disability Medicaid, and emergency Medicaid programs

  

May include weekends, holidays, or extended hours based on patient census and hospital needs.