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Medicaid Eligibility Specialist

2 months ago

Philadelphia, United States FREEDOM CARE , LLC Full time

Started in 2016, FreedomCare is a Healthcare company that is innovating and revolutionizing the way home care is delivered. We bring dignity and support to patients needing care in their homes and to the caregivers who care for them. We're the largest consumer-directed home care agency in NY State, and are continually expanding our areas of focus including operations in other states and tech-based innovations.

We pride ourselves on our values which drive the level of care that we deliver to our patients:

  • Here For You (An attitude of service, empathy, and availability)
  • Own It (Drive and ownership)
  • Do the Right Thing (High integrity)
  • Be Positive (Great attitude and a can-do positive approach to challenges)
Join our team and make a positive impact on the lives of others We are looking for a Medicaid Eligibility Specialist for our Pennsylvania Operations Team.

This is a hybrid role that requires a regularly scheduled commute/travel to our main office in Pittsburgh, Philadelphia, and/or the FreedomCare hub closest to you.

Department & Position Overview:

The Medicaid Eligibility Specialist focuses on enhancing the patient's experience by facilitating the approval process, to allow them to receive our service. The Medicaid Specialist responsible for expediting the time it takes for them to enroll into our programs.

The Specialist focuses on maintaining eligibility with current consumers' service by maintaining active Medicaid status through Medicaid recertification and monthly spend down obligations.

The Specialist will be responsible for ensuring compliance with all relevant regulations. The Specialist requires a high level of attention to detail, excellent communication skills, and requires in-depth knowledge and understanding of Medicaid policies, regulations, and procedures.

Every Day You Will:

Medicaid Eligibility
    • Provide clients with information and guidance on Medicaid eligibility requirements and benefits
    • Address client inquiries and concerns related to Medicaid applications, renewals, and coverage
    • Manage alternative resources for clients to meet Medicaid eligibility requirements
    • Conduct client education sessions on Medicaid programs and benefits
    • Subject matter expert relative to Pennsylvania Medicaid spenddown requirements through the clients' pre-care & on care status
Medicaid Renewal Processing:
    • Monitor and manage the Medicaid renewal process for existing clients
    • Notify clients of upcoming renewal deadlines and assist with the submission of required documentation
    • Ensure that renewals are processed in a timely manner to avoid lapses in coverage
Documentation and Record Keeping:
    • Maintain accurate and detailed records of verification processes and outcomes
    • Update patient records in salesforce to reflect current Medicaid status
    • Design Medicaid eligibility and spenddown process along with trackability reports in Salesforce
Communication:
    • Serve as a point of contact for Medicaid inquiries from clients, caregivers, and Health plan partners
    • Assist clients in understanding Medicaid eligibility, benefits, and application processes
    • Advocate for clients to ensure they receive appropriate Medicaid services
    • Respond to inquiries from patients and healthcare providers regarding Medicaid coverage and eligibility
Collaboration and Support:
    • Work closely with partnering departments to resolve any issues related to Medicaid coverage and recertification
    • Assist with training staff members on Medicaid verification procedures and policies
    • Collaborate with partnering departments, case managers, and other healthcare professionals to support patients' access to Medicaid benefits
    • Identify and resolve issues that may affect clients' Medicaid eligibility or coverage
    • Work with government agencies and other stakeholders to address and resolve complex Medicaid-related cases
Ideal Candidate Will Possess:
  • Associate's or Bachelor's degree in Social Work, Healthcare Administration, Public Health, or a related field preferred
  • Minimum of 2 years of experience in Medicaid, healthcare, or social services
  • Experience in client support, case management, or benefits coordination
  • Minimum of 2 years of understanding of the Medicaid eligibility and application process for the state of Pennsylvania
  • Excellent organizational and time management skills
  • Proficient in using case management software and other relevant technology
  • Strong communication and interpersonal skills, with the ability to work effectively with diverse populations
  • Ability to analyze complex information and make informed decisions

Why work at FreedomCare?

We are here for you and committed to providing a best-in-class employee experience. We offer competitive compensation, medical benefits, retirement plans, wellness programs, fun company events and ongoing learning opportunities to grow your career.

This is a place where your voice matters, where we build great relationships, and your work has meaning and a tangible positive impact on others

At FreedomCare, we celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based upon race, religion, color, national origin, ancestry, age, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, citizenship or immigration status, or other applicable legally protected characteristics.

#INDLV

At FreedomCare, base pay is one part of our total compensation package and is determined within a range. This provides our employees with the opportunity to professionally grow and develop within a role. The base pay range for this role is between $23.00 and $26.00 an hour at the commencement of your first year of employment. Compensation decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.

Salary Range

$23-$26 USD