Medicaid File Coordinator

2 weeks ago

Fort Pierce, United States The State of Florida Full time

Requisition No: 831784

Agency: Children and Families

Working Title: MEDICAID FILE COORDINATOR

Pay Plan: Career Service

Position Number: 60066289

**Salary**: 32,760.00

Posting Closing Date: 06/28/2024

**Total Compensation Estimator **Tool**

Florida Department of Children & Families - Office of Economic Self-Sufficiency

**_MEDICAID FILE COORDINATOR_**

**Description**: This position is charged with conducting case reviews per individual services site, administrative unit and supervisory unit in order to ensure compliance with state and federal regulations related to Medicaid eligibility determination and documentation. This position interacts with management, administrative and frontline staff and is responsible for analyzing data, completing written reports and training staff on identified error trends. The incumbent must have a demonstrated ability to perform in-depth case review techniques, as well as analyze case review information and display it in a manner useful for quality improvement for the worker, unit, and service center.

**Location**:

**Salary**: $32,760.00 -$65, 482.44 - Internal salary appointments are determined according to DCF Salary policy.

**_Minimum Qualifications:_**
- A bachelor’s degree from an accredited college or university and four years of professional experience in health, social, economic or rehabilitative programs.
- A master’s degree from an accredited college or university can substitute for one year of the required experience.
- Professional or nonprofessional experience as requires above can substitute on a year-for-year basis for the required college education. This includes,
- Previous experience in Florida Medicaid Eligibility determination, file coordination, data entry, or related administrative roles.
- Knowledge of State of Florida Medicaid processes and documentation requirements

**_Responsibilities include but are not limited to the following:_**
- Research and resolve Medicaid Eligibility file errors including rejected AHCA.
- Transactions, Update Error reports and SDX Error reports.
- Process CF-ES 2014’s and 5240’s (FMMIS File Resolution Forms).
- Distribute Nursing Home Discharge Reports to ICP units.
- Research, analyze, and process Medicare Buy-in program problems including the processing of Buy-in Inquiry forms.
- Serve as liaison and primary contact person for: AHCA, Momcare, Volunteers in Medicine, and Medicaid Providers.
- Resolve Third Party Liability issues.
- Track error trends as related to Medicaid eligibility and consult with region trainers and /or QA staff as trends are identified.
- Provide technical assistance to staff related to the Medicaid Eligibility File, including system and document completion assistance.
- Coordinate the completion of all Medicaid file error reports.
- Assure timely distribution, tracking and correction of all error reports.
- Access FLORIDA and FMMIS to review Medicaid eligibility.
- Complete CF-ES 2039 to verify eligibility or ineligibility if requested by the customer, the designated representative, or provider.
- Complete 2039’s for bill tracking.

**Special note**:

- Some Agency positions may require successful completion of pre-interview assessment or work sample prior to interview.
- Ability to speak/read/write Spanish/Creole/French or other foreign language may be considered in the selection process as determined by Agency need at time of interview.

**Preference will be given to applicants with Office of Economic Self-Sufficiency experience.**
- It is the policy of the Florida Department of Children and Families that any applicant being considered for employment must successfully complete a State and National criminal history check as a condition of employment before beginning employment, and, if applicable, also be screened in accordance with the requirements of Chapter 435, F.S., and Chapter 408, F.S. _**_No applicant may begin employment until the background screening results are received, reviewed for any disqualifying offenses, and approved by the Agency._**_ Background screening shall include, but not be limited to, fingerprinting for State and Federal criminal records checks through the Florida Department of Law Enforcement (FDLE) and Federal Bureau of Investigation (FBI) and may include local criminal history checks through local law enforcement agencies._

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

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