Medicaid Eligibility Representative, Inpatient Business Office

Job Description

Medicaid Eligibility Representative, First Shift, Inpatient Business Office

UC Health is hiring a full-time Medicaid Eligibility Representative for the Inpatient Business Office for the first shift at University of Cincinnati Medical Center.

The Medicaid Eligibility Representative will support the Medical Centers emergency room (ER) and Level III Trauma Center, delivering high-quality care to patients based on assessed needs, established standards of care and according to policy and procedures.

About University of Cincinnati Medical Center

As part of the Clifton Campus of UC Health, Greater Cincinnati's academic health system, University of Cincinnati Medical Center has served Greater Cincinnati and Northern Kentucky for nearly 200 years. Each year, hundreds of thousands of patients receive care from our world-renowned clinicians and care team. Our experts utilize the most advanced medical knowledge and technology available, providing a level of specialty and subspecialty medical care that is not available anywhere else in Greater Cincinnati.

UC Medical Center is also home to medical breakthroughs- our physician experts conduct basic, translational and clinical research, leading to new therapies and care protocols, and connecting patients to the latest and most advanced treatments. UC Medical Center houses Greater Cincinnati's only Level I adult trauma center, which includes the right mix of specialist and medical resources available at a moment's notice for a wide variety of the most complex medical conditions and injuries.


Job Responsibilities:
  • Interviews patients or their representative in person or by telephone using Benefit Screening to obtain financial and other eligibility data and assists patients in completing applications. Verifies accuracy of demographic and financial data and updates systems as needed. Obtains signatures for various Federal, State, and/or Local assistance programs. Assists the patient, when necessary, in completion of the application(s) to include doing the required reading, writing, and/or explanation of the document(s) and/or required verifications.
  • Analyzes financial and eligibility data and reviews length of disability to determine potential eligibility for Federal, State and County programs; completes the necessary documents within the time limits specified by the appropriate government agency.
  • Determines the patient's ability to reimburse the hospital; interviews and corresponds with patients, responsible relatives, attorneys, employers, agencies, and insurance companies to obtain, verify or clarify information.
  • Reviews prior account notes and uses established methods to obtain information that might aid in the application process or establish there is existing third-party coverage.
  • Updates system(s) as required with demographic information, account/guarantor notes, third party updates, etc...
  • Determines and manages proper course of action for optimal reimbursement of healthcare charges (i.e., Spend Down eligibility, Cobra coverage, etc.)
  • Decides on appropriateness and refer specific accounts to the Financial Counselor, Eligibility Vendors, County Department of Job and Family Services, etc.


Education and Experience Requirements:
  • Minimum Required: High School Education or GED; Associate degree is preferred.
  • 1-2 years of office experience is required.
  • 2 years interviewing the public in connection with applications for financial assistance or relevant experience in the healthcare revenue cycle and/or epic Revenue Cycle applications is preferred.
  • General knowledge of hospital insurance plans, reimbursement and Medicare regulations.
  • General knowledge of federal and state Medicaid laws and regulations.
  • Working knowledge of Microsoft Word and Excel.
  • General Knowledge of Social Security Disability and Supplemental Security Income program requirements.
  • Strong analytical and communication/interviewing skills, including verbal, non-verbal and listening skills.
  • Must be able to work in a high stress environment while acknowledging customers' emotional needs brought about by difficult medical situations.
  • Ability to work in situations indigenous to a hospital environment.

Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!

About UC Health

UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at