Patient & Eligibility Specialist

Position:Patient Benefits & Eligibility Specialist

Location: Surprise, AZ

Job :526

# of Openings:1

Patient Benefits & Eligibility Specialist

Avenir Behavioral Health Center is seeking a compassionate, detail-oriented Patient Benefits & Eligibility Specialist to assist uninsured patients with obtaining healthcare coverage, primarily through the Arizona Health Care Cost Containment System (AHCCCS/Medicaid).

This position is responsible for meeting directly with newly admitted patients to assess potential eligibility, facilitate application completion and submission, obtain necessary documentation, and provide ongoing follow-up throughout the eligibility determination process.

The ideal candidate will possess documented relevant experience, strong organizational and communication skills, demonstrate patience and professionalism, and be comfortable working face-to-face with individuals receiving acute inpatient psychiatric treatment.

This is initially a part-time, hourly position, with the potential to transition to full-time employment based on hospital needs, patient volume, and organizational growth.

• Identify newly admitted patients who are uninsured or may qualify for AHCCCS coverage.
• Meet face-to-face with patients on inpatient units or in designated interview areas to assess potential eligibility and initiate the application process.
• Conduct patient interviews to gather demographic, financial, employment, residency, and household information required for AHCCCS applications.
• Explain eligibility requirements, application procedures, and necessary documentation in a clear, respectful, and understandable manner.
• Assist patients who may experience difficulty participating in the application process due to psychiatric symptoms, cognitive limitations, or other barriers.
• Coordinate with nursing and clinical staff to determine appropriate times for patient interviews based on clinical presentation and ability to participate.
• Maintain appropriate professional boundaries and follow all hospital safety protocols during patient interactions.

• Assist patients with completing and submitting AHCCCS applications through Health-e-Arizona Plus (HEAplus) or other approved application methods.
• Review applications for accuracy, completeness, and consistency prior to submission.
• Obtain and organize required supporting documentation, including identification, residency verification, income information, and other eligibility-related records.
• Assist patients in obtaining missing documentation when reasonably possible.
• Obtain appropriate signatures, authorizations, and consents in accordance with applicable requirements.
• Coordinate with legally authorized representatives, guardians, or other appropriate parties when necessary and permitted.
• Ensure applications are submitted promptly and in accordance with applicable AHCCCS requirements.

• Maintain an accurate and organized tracking system for all applications initiated or managed.
• Monitor application status and identify outstanding documentation, verification requests, or other deficiencies.
• Communicate with AHCCCS, the Arizona Department of Economic Security (DES), and other appropriate agencies to facilitate application processing and resolve outstanding issues.
• Conduct follow-up meetings with patients as necessary to obtain additional information or complete application requirements.
• Coordinate appropriate follow-up after patient discharge when necessary and authorized.
• Document eligibility determinations, effective coverage dates, denials, and other relevant outcomes.
• Communicate application progress and final…