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Eligibility Specialist I
1 month ago
McGregor PACE
Responsible for facilitating Medicaid renewals for all McGregor PACE participants. Responsible for maintaining an accurate census for McGregor PACE. Maintain active/inactive participant status in Truchart and all other software systems assigned. Perform collections for private/share of cost accounts.
ESSENTIAL DUTIES
- Initiates and conducts appointments with current participants and applicants; to obtain all necessary authorizations and pertinent paperwork for submission to Special Medicaid Benefits Center (SMBC for Medicaid eligibility renewal. Responds to participant questions regarding Medicaid status and benefits.
- Acts as Medicaid Authorized Representative for all McGregor participants
- Expeditiously follows up on all aspects of application/renewal process with SMBC and other organizations for applicants and current participants as needed to obtain needed verifications to determination eligibility for Medicaid and Medicare benefits.
- Consistent communication with Eligibility Manager and staff regarding delays that will affect applicants and current participant’s ongoing program eligibility.
- Documents and records all activities during the Medicaid application and renewal process.
- Serves as a resource to participants/residence, families and PACE staff for Medicaid eligibility.
- Responsible for McGregor PACE AR aging, makes collection calls, and institutes payment plans after past due letters have been mailed. Documents all collection activity in Truchart.
- Responsible for preparation of CMS reporting and communication requirements.
- Responsible for maintaining Truchart enrollments/disenrollments as active/inactive within appropriate modules and all other software systems assigned.
- Send out temporary and permanent PACE medical cards.
- Other duties as assigned.
QUALIFICATIONS
- One-year experience in home or community-based Medicaid waiver programs and health/social services program preferred
- At least one year of experience working with older adults, especially dementia, preferred.
- Up to date working knowledge and some experience in Ohio Medicaid and Federal Medicare regulations/systems preferred.
- Current Ohio driver’s license and reliable car required
- Basic proficiency in Windows and Word, Excel and Power Point preferred. Public speaking and presentation skills; strong communication skills preferred.
- Bachelor’s degree preferred
Must have reliable transportation and a valid Ohio driver’s license.
EOE Pre-hire background check, and physical required.
Great pay Great benefits Ready to Hire
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