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Medicaid Enroll&Outrch Spc I
4 months ago
POSITION SUMMARY: Counsels, guides, advises and provides outreach services to patients requiring public benefits including; Medicaid, Child Health Plus, NYS Marketplace Exchange or other public entitlements. Accountable for coordinating all activities and necessary documentation needed to secure appropriate benefits. Resolves complex problems related to this process. Shares expert public benefits knowledge by providing consultation to physicians, social workers and other Health System staff whose patients require benefit assistance for payment and discharge planning. Demonstrates ICARE values. This role may have the option to work a Hybrid-remote schedule and communicates daily through virtual meetings. **SUPERVISION AND** **DIRECTION EXERCISED:** Self-directed: must make complex decisions independently. Seeks assistance from Senior FCM, Operations Supervisor, Operations Manager or Department Manager. Responsible to prioritize, monitor and resolve caseload in a timely fashion. Provides information and direction regarding public benefits to other areas of the University of Rochester Health Systems. **MACHINES AND** **EQUIPMENT USED:** Standard office equipment, including but not limited to: telephone, pneumatic tube system, personal computer, printer, photo copier, fax machine, hospital financial system, electronic third party payer systems, page system, document scanner, automobile and gas pump. **TYPICAL DUTIES:** 1. **_Benefit Management:_** Provides outreach services to patients referred by University of Rochester Health System staff through face to face interaction, telephone contact and home visitation for patients requiring assistance with benefit application. FCMs apply for benefits via computer systems and/or paper application and may accompany or represent the patient at eligibility interviews, case conferences or fair hearings (30%) essential. 2. **_Referral Coordination:_** Responsible for assessing referrals to determine eligibility for potential benefits and develops a plan of action to secure each. Communicates, coordinates and develops professional relationships with internal departments: Financial Counseling, Social Work, Patient Financial Services, Financial Assistance Program, RIM, Office of Counsel and Clinicians. External coordination includes families, community physicians, Department of Social Services, Social Security, Veterans' Administration, Homeland Security, advocacy groups and other agencies. (30%) essential. 3. **_Problem Resolution:_** Identifies barriers to securing public benefitswhich may impact hospital reimbursement and timely discharge. Consults with Senior FCM, Operations Supervisor or Manager to develop, coordinate and implement plans to successfully resolve barriers. (15%) essential. 4. **_Monitoring Caseload:_** **_Documentation and Reports:_** FCM Monitors caseload and is responsible for accurate and timely documentation in requisite systems: Medicaid Data Base, EPIC, NY State of Health (NYSOH) application and OnBase scanning. FCM reviews productivity reports and prepares status updates as required by management. (20%) essential. 5. **_Continuing Education:_** Attends seminars and reviews Federal and N.Y. State regulations, UR Medicine mandatory training requirements, NYSOH Marketplace Certified Application Counselor Seminars and literature to maintain expert knowledge of public benefit programs. (3%) essential. 6. **_Safety Precautions:_** Exercises professional judgment to determine whether or not a home visit is a safety risk. Keeps direct supervisor advised of planned visits and takes appropriate safety precautions. Operates a motor vehicle for outreach purposes. Ensures all safety precautions are taken during vehicle operation. Adheres to safety precautions involving mask, gown and glove usage (2%) essential. **QUALIFICATIONS:** Bachelor's degree in Psychology, Sociology, Social Work or Business Administration and 1 - 2 years related experience such as a Medicaid Eligibility Examiner or Medicaid Eligibility Supervisor; or an equivalent combination of education and experience. Knowledge of public benefit rules and regulations preferred. Requires a high degree of professionalism; must be motivated, an excellent communicator and writer, possesses customer service skills and the ability to work independently in an interdisciplinary team environment. Must provide and maintain a valid NYS Class 5 driver's license. NYSOH CAC certification preferred but not required. **NOTE:** **This document describes typical duties and responsibilities and is not intended to limit management from assigning other work as required.** The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University's mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations. **How To Apply** All applicants must apply online. _EOE Minorities/Females/Protected Veterans/Disabled_ **Pay Range** Pay Range: $ 23.28 - $ 29.86 Hourly _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._ Apply for Job + Careers + Sign In + New User **Location:** Strong Memorial Hospital **Full/Part Time:** Full-Time **Opening:**
