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Medicaid Enrollment Specialist
4 months ago
Iona is pleased to announce that we are hiring a full-time Medicaid Enrollment Specialist for our Washington Home Center location
**About Iona**
Iona is a warm and collegial workplace that promotes excellence in client services and is committed to diversity, inclusion, and the professional growth of employees.
**SUMMARY**:
**RESPONSIBILITIES**:
**Enrollment**:
- Oversees admission process into the Center with emphasis on managing the enrollment funnel to grow the program to capacity and meet budgeted revenue goals.
- Facilitate enrollment process through initial interview, tour, guest day and initial data collection.
- Ensure each incoming participant has a funding source and navigates them through the necessary stages to enroll in that funding source.
- This includes Medicaid, private pay, sliding scale/cost sharing, VA or other future sources.
- Track all enrollment progress in Iona’s established systems (i.e. Access)
- Community outreach including building relationships with potential referral sources.
- Respond to inquiries and effectively present program information to clients, referral sources, and caregivers.
- Ensure that all necessary materials for enrollment are provided to the responsible party promptly.
- Strive toward capacity enrollment.
- Communicate pertinent financial information and resources such as rates, financial support tools, and scholarships.
- Manage medical chart for admissions and discharge process.
- Support Director with maintaining up to date client information in Iona’s internal spreadsheets/ Electronic Management System
**Medicaid Management**:
- Facilitate the enrollment of eligible Medicaid participants and assist in developing policies to ensure Medicaid enrollment.
- Support Director with Medicaid Compliance
- Including: Application submission for UHC, Stateplan and EPD Waiver
- Conduct internal audits twice a year to ensure compliance.
- Keep up to date with Medicaid changes/updates and inform Assistant Director and Director of pertinent information.
- Attend weekly and monthly Medicaid meetings.
- Review Transmittals
- Complete Medicaid’s Quarterly Snapshot Sheets and Quarterly Reports.
- Follow through with DHCF for any billing issues or discrepancies.
- Identify potential Medicaid participants during the enrollment process.
- Actively support Caregiver in Application from start to finish.
- Ensure participant recertification process from EPOF to PA in consultation with social worker.
**Billing**:
- Manage accurate monthly billing for all participants from start to finish. This includes:
- Keep attendance tracking for billing purposes.
- Enter attendance into billing data management spreadsheet/system to submit to finance.
- Assure all attendance data and billing data are complete and accurate.
- Maintain clear communication with Iona’s finance department for any billing issues or discrepancies.
- Assure DHCF reimbursement for services is up to date.
**Community Outreach**:
- Community outreach including building relationships with DACL MES, Case Managers and other Medicaid affiliated agencies.
**Other**:
- Other duties as assigned.
**REQUIREMENTS**:
- Bachelor’s degree in the human service field required. Certification in healthcare administration, medical billing and coding, or a related field preferred.
- Mandatory 3+ years' experience working in healthcare administration, insurance verification, medical billing, customer service, or a related field is often preferred.
- A strong understanding of Medicaid eligibility criteria, enrollment procedures, and regulations is essential.
- Must possess exceptional verbal and written communication skills.
- Strong customer service skills.
- Strong organizational skills and attention to detail.
- Knowledge of healthcare privacy laws, such as HIPAA, and adherence to confidentiality guidelines are essential.
- The ability to troubleshoot problems, analyze information, and find solutions.
- Computer literacy with proficiency in Microsoft Office Suite required.
- Initial and annual chest x-ray/PPD or medical certification required.
- First aid and CPR certification required.
Iona has a robust benefits package which includes health, dental, and life insurance, vacation, and a 403(b)-retirement plan. Compensation is commensurate with experience.
Pay: $60,000.00 - $65,000.00 per year
**Benefits**:
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Retirement plan
- Vision insurance
Schedule:
- 8 hour shift
**Education**:
- Bachelor's (required)
**Experience**:
- Medicaid enrollment: 2 years (required)
License/Certification:
- Certification in Healthcare Administration, Medical Billing (required)
Ability to Relocate:
- Washington, DC 20020: Relocate before starting work (required)
Work Location: In person
