803 Eligibility Coordinator jobs in the United States

Benefits & Eligibility Coordinator

Gaithersburg, MD, USA

Full-time

Today is a new day. At Asbury were filling it with more laughter, more possibilities, more ways to give back, all backed by support for whatever life brings your way. We are an organization with a mindset to help others, a place where seniors continue to teach, learn, and grow, a certified Great Place to Work where you can build a purposeful career. Lets do all the good we can in this world together.

Full-time Opportunity, Gaithersburg, MD ( Work Location)

Compensation Range: $75,000 - $85,000 annually

We are seeking a detail-oriented and knowledgeable Benefits & Eligibility Coordinator to oversee Medicaid billing and application processes at our Gaithersburg, MD community, Asbury Methodist Village. In this key role, you will serve as the subject matter expert on Medicaid, managing resident eligibility, and ensure compliance with all State and County guidelines. Youll also oversee resident funds programs and play a vital role in maintaining the financial health of our Skilled Nursing Facilities.

What Youll Do

• Manage the Medicaid application and reapplication process for residents, including complex cases, ensuring compliance with regulations.
• Oversee intake and eligibility verification for Skilled Nursing Facilities, developing systems to confirm payer coverage before admission.
• Lead the resident funds program (RFMS) and banking system, ensuring timely and compliant processing of refunds and transactions.
• Track Medicaid Pending aging, support Facility Billing Counselors, and update resident income changes.
• Collaborate on collection activities, including monitoring Resident Responsibility Accounts Receivable and referring cases to outside agencies as needed.
• Guide policy development and updates related to Medicaid processes and ensure adherence to safety management standards.

Required Qualifications

• Bachelors degree in a related field or equivalent experience
• 25 years of Medicaid, Medicare, and third-party billing/application experience
• 12 years of accounting experience with computerized systems
• Strong attention to detail, organization, and communication skills
• Proficient in Microsoft Office; comfortable with databases/software systems

Preferred Qualifications

• Prior knowledge of the Maryland Medicaid program
• Experience developing process improvements and efficiencies
• Ability to think strategically and support policy or program enhancements
• Familiarity with resident funds programs and/or healthcare-related financial systems

Depending upon the status of the position, Asbury offers generous benefits including medical, dental, and vision coverage; 401K with match; PTO and paid holidays.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

Job Description

TITLE : Patient Eligibility Coordinator (PEC)

REPORTS TO : Provider and Patient Coordinator Manager
WORK WEEK : Not to exceed 40 hours per week
WAGE CLASSIFICATION: Non-Exempt
OSHA RISK CLASSIFICATION : Medium
STARTING SALARY : $21.00 per hour with benefits

SUMMARY POSITION STATEMENT

Under the supervision of the Provider and Patient Coordinator Manager, working closely with the CFO, this position conducts enrollment activities for PCHS to identify, contact and enroll uninsured patients and community members into health insurance coverage. Assists all PCHS staff with processes that identify uninsured patients and enroll them in insurance for which they qualify. Participates in outreach activities on behalf of PCHS. PCHS manages patient care using a team-based approach in our interactions with patients and working to achieve stated objectives and outcomes.

• Assist qualified patients to enroll into Sliding Fee discount and then determine their eligibility for same. 
• Facilitate the process for patients to access outside financial assistance.  
• Provide information to patients and clients about PCHS’s policies and procedures as they pertain to enrollment and eligibility for available financial programs. 

• Functions in accordance with and in support of PCHS’s mission, vision, policies and procedures.
• Check Insurance eligibility for patient coverage in advance of scheduled appointments by scrubbing provider schedules. Contact any patient whose insurance fails eligibility to obtain current insurance information prior to patient appointment.
• Assist patients who need help filling out agency paperwork. At time of patient check-in, assist all new patients as well as existing patients in need with the registration process including reviewing insurance coverage and eligibility for Medicare, Medicaid, Marketplace, and Sliding Fee Discount Program. Assist patients in gathering their data.  Assure completeness of clinic forms.
• Interview patients to assist with and begin the process to access financial assistance; procure necessary paperwork from patients, including proof of income and any other pertinent documents. Determine a patient’s eligibility for PCHS’s in-house discount/sliding fee scale, input sliding fee information into the practice management system.
• Update patient eligibility and financial information on a regular basis as required under the Sliding Fee Discount Program.
• Establish a positive working relationship with outside agencies; develop a collaborative working relationship with contact person.
• Coordinate with in-house case managers and community resources to facilitate a patient/client application process to outside agencies; whenever applicable, do an intra-agency referral to a case manager.  All billable services will be referred to an appropriate in-house staff member.
• Access and have a basic understanding of all agency practice management systems.
• Specifics required by ACA law:
  The navigators are expected to provide “fair, impartial, and accurate information that assists consumers with submitting the eligibility application, clarifying distinctions about qualified health plans and helping qualified individuals make informed decisions during the health plan selection process”.  They will also provide additional assistance to consumers, who are disabled, do not speak English, or who are unfamiliar with health insurance. 
  
  The proposed guidelines specify that while navigators do not have to be licensed insurance agents or brokers, they:
   
• Cannot be employed by an insurer;
• Cannot receive compensation or rewards from carriers;
• Must disclose what other lines of insurance they intended to sell during their work;
• Must disclose any prior employment with health insurers in the previous five years; and
• Must certify that they will abide by conflict of interest and impartiality standards developed by HHS.
• 
  The proposed rule also states that navigators cannot select a plan for their clients, and that they are not tasked with determining whether a client is eligible for a subsidy through the ACA.
  
  Navigator must not have a personal interest in the coverage choices made by individuals or employers who receive the navigator’s assistance, “More specifically, with respect to the assistance offered by a navigator to a small employer, a navigator should not have a personal interest in whether a small employer choose to self-insure its employees or chooses to enroll in full-insured coverage inside or outside the exchange.” 

Must pass drug test and State required background.  
 

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**General Healthcare Clerical Positions** for entire company

Recruiting Solutions is seeking General Healthcare Clerical candidates for a variety of companies. If you have experience with for any of the following types of positions and did not see any other positions you would be a good fit for, please feel free to apply to this General Healthcare Clerical position. We have temp-to-perm and direct hire opportunities for the following.

General Healthcare Clerical positions that come available include:

• AR Manager
• BI Analyst
• Cash Posting Associates & Managers
• Clinical Appeals Auditor
• Clinical Appeals Nurse
• Hospital Revenue Cycle Managers & Directors
• Medical Billing & Coding
• Nurse Manager
• Outpatient Coder
• Patient Accounting Associate
• Programming Manager
• Reconciliation Accountant
• Risk Adjustment Coders
• SQL Analyst
• Test Analyst
• Web Programmer

• Oversee the day-to-day administrative operations of designated healthcare departments.
• Develop and implement strategies to improve operational efficiency and patient flow.
• Manage administrative staff, including hiring, training, scheduling, and performance evaluation.
• Ensure compliance with all relevant healthcare laws, regulations, and accreditation standards.
• Manage departmental budgets, control expenses, and identify cost-saving opportunities.
• Develop and implement policies and procedures to enhance administrative processes.
• Collaborate with clinical leadership and other departments to ensure seamless operations.
• Oversee the implementation of new administrative systems and technologies.
• Monitor key performance indicators (KPIs) and generate reports for senior management.
• Resolve operational issues and implement solutions to improve service delivery.

• Master's degree in Healthcare Administration, Business Administration, or a related field.
• Minimum of 7 years of experience in healthcare operations management, with a focus on administrative functions.
• Strong knowledge of healthcare regulations (e.g., HIPAA, CMS) and compliance requirements.
• Proven experience in process improvement, workflow optimization, and change management.
• Excellent leadership, team management, and communication skills.
• Proficiency in budgeting, financial management, and data analysis.
• Ability to work independently and effectively manage operations in a remote setting.
• Experience with EMR/EHR systems and healthcare IT solutions is a plus.
• Strong problem-solving and decision-making abilities.

What Benefits Eligibility and Authorization (RCM) contributes to Cardinal Health

Practice Operations Management oversees the business and administrative operations of a medical practice.

This position is responsible for reviewing the physician's daily schedule and obtaining verification of patients' insurance benefits for their scheduled visits. ?They will also obtain authorization for all requested procedures, tests, drugs, etc. The Senior Coordinator, Benefits Eligibility and Authorization may be asked to perform other duties if necessary & must be knowledgeable of a variety of Insurance Plans and Policie

Responsibilities

• Submit authorizations for all internal and external orders including but not limited to radiation, chemotherapy, PET/CT, urology and scans

• Follow up within 48 hours on any existing authorizations that are pending approval

• Ensure proper documentation outlining all steps taken to ensure authorizations have been submitted, followed up on and obtained.

• Upon approval, enter all authorization information into the billing system and attach confirmation into the patients account in registration overlay

• Take any action necessary for any denials received by the payor to inform the clinician of changes that may need to happen in order to not delay patient care.

• Complete any pre-service appeals to obtain paying approval based on medical necessity.

• Communicate effectively with all RCM and clinical staff to ensure appropriate treatment can be provided, claims can be processed accurately and timely payment received.

• Maintain a high level of confidentiality for patients in accordance to HIPAA standards.

• Coordinate with clinical staff to ensure patients are contacted prior to appointments informing them of any treatment schedule changes if necessary.

• Effectively completes other duties and projects as assigned.

• Regular attendance and punctuality

• Execute all functions of the role with positivity and team effort by accomplishing related results as needed.

• Effectively completes other duties and projects as assigned

Qualifications:

• High School Diploma or equivalent preferred

• 3-4years' experience preferred

• Strong customer service background, preferably in health care environment

• Excellent verbal communication skills

• Competence with computer processing functions and other standard office equipment

• Ability to manage and prioritize multiple tasks

• Ability to work independently with minimal supervision

• Strong organizational skills Anticipated hourly range: $21.00 - $26.45 USD Hourly Bonus eligible: No Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage

• Paid time off plan

• Health savings account (HSA)

• 401k savings plan

• Access to wages before pay day with myFlexPay

• Flexible spending accounts (FSAs)

• Short- and long-term disability coverage

• Work-Life resources

• Paid parental leave

• Healthy lifestyle programs Application window anticipated to close: 11/05/2025 *if interested in opportunity, please submit application as soon as possible.The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

To read and review this privacy notice click here (

What Benefits Eligibility and Authorization (RCM) contributes to Cardinal Health

Practice Operations Management oversees the business and administrative operations of a medical practice.

This position is responsible for reviewing the physician's daily schedule and obtaining verification of patients' insurance benefits for their scheduled visits. ?They will also obtain authorization for all requested procedures, tests, drugs, etc. The Senior Coordinator, Benefits Eligibility and Authorization may be asked to perform other duties if necessary & must be knowledgeable of a variety of Insurance Plans and Policie

Responsibilities

• Submit authorizations for all internal and external orders including but not limited to radiation, chemotherapy, PET/CT, urology and scans

• Follow up within 48 hours on any existing authorizations that are pending approval

• Ensure proper documentation outlining all steps taken to ensure authorizations have been submitted, followed up on and obtained.

• Upon approval, enter all authorization information into the billing system and attach confirmation into the patients account in registration overlay

• Take any action necessary for any denials received by the payor to inform the clinician of changes that may need to happen in order to not delay patient care.

• Complete any pre-service appeals to obtain paying approval based on medical necessity.

• Communicate effectively with all RCM and clinical staff to ensure appropriate treatment can be provided, claims can be processed accurately and timely payment received.

• Maintain a high level of confidentiality for patients in accordance to HIPAA standards.

• Coordinate with clinical staff to ensure patients are contacted prior to appointments informing them of any treatment schedule changes if necessary.

• Effectively completes other duties and projects as assigned.

• Regular attendance and punctuality

• Execute all functions of the role with positivity and team effort by accomplishing related results as needed.

• Effectively completes other duties and projects as assigned

Qualifications:

• High School Diploma or equivalent preferred

• 3-4years' experience preferred

• Strong customer service background, preferably in health care environment

• Excellent verbal communication skills

• Competence with computer processing functions and other standard office equipment

• Ability to manage and prioritize multiple tasks

• Ability to work independently with minimal supervision

• Strong organizational skills Anticipated hourly range: $21.00 - $26.45 USD Hourly Bonus eligible: No Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage

• Paid time off plan

• Health savings account (HSA)

• 401k savings plan

• Access to wages before pay day with myFlexPay

• Flexible spending accounts (FSAs)

• Short- and long-term disability coverage

• Work-Life resources

• Paid parental leave

• Healthy lifestyle programs Application window anticipated to close: 11/05/2025 *if interested in opportunity, please submit application as soon as possible.The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

To read and review this privacy notice click here (

Practice Operations Management oversees the business and administrative operations of a medical practice. This position is responsible for reviewing the physician's daily schedule and obtaining verification of patients' insurance benefits for their scheduled visits. They will also obtain authorization for all requested procedures, tests, drugs, etc. The Senior Coordinator, Benefits Eligibility And Authorization may be asked to perform other duties if necessary and must be knowledgeable of a variety of insurance plans and policies.

Responsibilities:

• Submit authorizations for all internal and external orders including but not limited to radiation, chemotherapy, PET/CT, urology and scans
• Follow up within 48 hours on any existing authorizations that are pending approval
• Ensure proper documentation outlining all steps taken to ensure authorizations have been submitted, followed up on and obtained.
• Upon approval, enter all authorization information into the billing system and attach confirmation into the patients account in registration overlay
• Take any action necessary for any denials received by the payor to inform the clinician of changes that may need to happen in order to not delay patient care
• Complete any pre-service appeals to obtain paying approval based on medical necessity
• Communicate effectively with all RCM and clinical staff to ensure appropriate treatment can be provided, claims can be processed accurately and timely payment received
• Maintain a high level of confidentiality for patients in accordance to HIPAA standards
• Coordinate with clinical staff to ensure patients are contacted prior to appointments informing them of any treatment schedule changes if necessary
• Effectively completes other duties and projects as assigned
• Regular attendance and punctuality
• Execute all functions of the role with positivity and team effort by accomplishing related results as needed

Qualifications:

• High School Diploma or equivalent preferred
• 3-4 years' experience preferred
• Strong customer service background, preferably in health care environment
• Excellent verbal communication skills
• Competence with computer processing functions and other standard office equipment
• Ability to manage and prioritize multiple tasks
• Ability to work independently with minimal supervision
• Strong organizational skills

Anticipated hourly range: $21.00 - $26.45 USD Hourly

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before pay day with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs

Application window anticipated to close: 11/05/2025 if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and veterans are encouraged to apply. Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

What Benefits Eligibility and Authorization (RCM) contributes to Cardinal Health

Practice Operations Management oversees the business and administrative operations of a medical practice.

This position is responsible for reviewing the physician's daily schedule and obtaining verification of patients' insurance benefits for their scheduled visits. ?They will also obtain authorization for all requested procedures, tests, drugs, etc. The Senior Coordinator, Benefits Eligibility and Authorization may be asked to perform other duties if necessary & must be knowledgeable of a variety of Insurance Plans and Policie

Responsibilities

• Submit authorizations for all internal and external orders including but not limited to radiation, chemotherapy, PET/CT, urology and scans

• Follow up within 48 hours on any existing authorizations that are pending approval

• Ensure proper documentation outlining all steps taken to ensure authorizations have been submitted, followed up on and obtained.

• Upon approval, enter all authorization information into the billing system and attach confirmation into the patients account in registration overlay

• Take any action necessary for any denials received by the payor to inform the clinician of changes that may need to happen in order to not delay patient care.

• Complete any pre-service appeals to obtain paying approval based on medical necessity.

• Communicate effectively with all RCM and clinical staff to ensure appropriate treatment can be provided, claims can be processed accurately and timely payment received.

• Maintain a high level of confidentiality for patients in accordance to HIPAA standards.

• Coordinate with clinical staff to ensure patients are contacted prior to appointments informing them of any treatment schedule changes if necessary.

• Effectively completes other duties and projects as assigned.

• Regular attendance and punctuality

• Execute all functions of the role with positivity and team effort by accomplishing related results as needed.

• Effectively completes other duties and projects as assigned

Qualifications:

• High School Diploma or equivalent preferred

• 3-4years' experience preferred

• Strong customer service background, preferably in health care environment

• Excellent verbal communication skills

• Competence with computer processing functions and other standard office equipment

• Ability to manage and prioritize multiple tasks

• Ability to work independently with minimal supervision

• Strong organizational skills Anticipated hourly range: $21.00 - $26.45 USD Hourly Bonus eligible: No Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage

• Paid time off plan

• Health savings account (HSA)

• 401k savings plan

• Access to wages before pay day with myFlexPay

• Flexible spending accounts (FSAs)

• Short- and long-term disability coverage

• Work-Life resources

• Paid parental leave

• Healthy lifestyle programs Application window anticipated to close: 11/05/2025 *if interested in opportunity, please submit application as soon as possible.The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

To read and review this privacy notice click here (