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Medicaid Managed Care Liaison
2 months ago
Description
Join Our Mission
The Medicaid Managed Care Liaison is responsible for ensuring coordination of care with internal and external stakeholders while assuring and monitoring access to health care for youth and families. Experience as a Patient Account Representative, Health Information Clerk, Medical Records Analyst, or other related field required.
Job Responsibilities
+ Serve as the primary point of contact for the Medicaid Managed Care Plan. This includes but is not limited to assisting with enrollment/disenrollment, transitions, notifications, prior authorizations, concurrent reviews, replacement insurance cards, consent and/or confidentiality issues.
+ Communicate with clinical and billing staff in a timely manner as it relates to consent, claims issues and other activities related to enrollment and other issues.
+ Ability to review and understand insurance claims.
+ Coordinate with the Medicaid Managed Care Plans' Foster Care Coordinator.
+ Inform and coordinate with Medicaid Managed Care Plan when a childs primary care provider needs to be changed.
+ Support with foster care placement changes including access to health care services.
+ Assist with facilitating a single case agreement when a child is placed outside of the Medicaid Managed Care Plan's service area or provider network.
+ Coordinate with health care providers in the selection and referral of medical care programs and health services including school and community based programs.
Job Requirements
+ High School Diploma or GED REQUIRED, Associates Degree strongly preferred.
+ Minimum 1 year of experience as a Patient Account Representative, Health Information Clerk, Medical Records Analyst, or other related field REQUIRED.
+ Required Skills: Experience with electronic health record databases and insurance portal(s), proficiency in Microsoft Applications (excel, Word, Outlook) and ability to conduct independent research.
+ Strong communication skills REQUIRED. Must be able to communicate professionally both verbally and written with community partners, stakeholders, clients and providers.
+ Demonstrated ability to handle confidential and sensitive information with extreme discretion, demonstrated knowledge of HIPAA regulations REQUIRED.
+ 2 years of experience with medical coding and billing review strongly preferred.
+ Must have a current, valid drivers license.
+ Ability to work with economically and culturally diverse population.
Salary Range:
+ $19.47 - $20.91 per hour
Equal Opportunity Employer
Berkshire Farm Center & Services for Youth is an equal opportunity employer and does not discriminate on the basis of age, race, creed, color, national origin, sexual orientation, military status, sex, pregnancy, gender identity or expression, disability, marital status, or any other basis covered by appropriate law.
We are committed to fostering an inclusive, equitable, and accessible environment where diversity is valued and recognized as a source of strength and enrichment. We seek to attract talented people from a diverse range of backgrounds and cultures.
As a federal contractor, Berkshire Farm Center & Services for Youth will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information. 41 CFR 60-1.35(c)
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