Program Coordinator- Patient Financial Assistance Case Management

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

 

About Duke University Hospital

 

Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States and is the number one hospital in North Carolina, according to U.S. News and World Report for 2023-2024. Duke University Hospital is the largest of Duke Health's three hospitals and features 1048 patient beds, 65 operating rooms, as well as comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Plan, coordinate and administer activities within assigned program areas; develop, coordinate and advise on policy related to assigned major programs.

 

Work Performed

• Ensure that the Social Security and Medicaid application for uninsured patients that require sponsorship on the Sharepoint site have been completed prior to sponsored hospital discharge.
• Actively assist and follow patients requiring sponsorship on the Sharepoint site through completion of the Medicaid and Social Security process.
• Serve as an educatiOnal resource for Patient/Family, their Case Manager and Medical Team on Social Security and Medicaid issues for patients identified with potential sponsorship needs.
• Advise patients on complex financial concepts and procedures of applying for disability benefits.  In some cases, may act as the authorized patient representative for the purpose of initiating an application for benefits and for conducting any and all activities associated with determination of eligibility of benefits, including the initiation and conduct of administrative and/or judicial appeals. 
• Follow-up with patient, the Department of Social Services, and the Social Security Administration to ensure all pertinent information has been provided relevant to the patient’s application.  This may require travel to county of patient residency for the purpose of providing information or transporting the patient to the Department of Social Services of Social Security Office for follow-up visits, obtaining additional records, and verifying or correcting information on behalf of the patient.
• Review sponsorship case files to determine issues and sufficiency of evidence of documentation, analyzing Social Security Administration rules, Division of Medical Assistance guidelines and relevant regulations for applicability.  Initiate fact finding research in support of denial of case merit.  Verify the patient’s potential eligibility for Medicaid and/or Social Security benefits.
• Prepare hearing briefs, assemble documentary evidence and exhibits to represent the patient at Medicaid and/or Social Security Hearings for the purpose of reversing a negative disability decision. 
• Submit and track invoices and reimbursements for sponsored patients on the Sharepoint site.
• Document all pertinent information in Case Management Notes and/or the Sharepoint system.  Update the Sharepoint site for monthly leadership review.
• Track and document benefit information on uninsured patients with identified sponsorship needs for use at length of stay meeting for DUH CSUs.
• Perform other related duties incidental to the work described herein. 

 

Future State:

• Follow non-sponsored, unfunded patients who are high utilizers or are frequently readmitted to assess for Medicaid/SSI/SSDI edibility.
• Complete the social security application with patients identified by Case Management as high dollar where the MAC worker has initiated the Medicaid application.
• Plan, coordinate and administer activities of assigned programs to perform other related duties incidental to the work described herein. appropriate recommendations o