Eligibility and Financial Determination Specialist

4 days ago


Philadelphia, Pennsylvania, United States InnovAge Full time
Job Summary

We are seeking a highly skilled Eligibility and Financial Determination Specialist to join our team at InnovAge. In this role, you will be responsible for overseeing the Medicaid applications submitted on behalf of our participants to the County Technicians.

Key Responsibilities
  • Review applications from the Enrollment Representative Group and work closely with them to obtain necessary documentation for Medicaid approval.
  • Develop and maintain a tracking system to monitor applications received and their status from first submission to approval.
  • Ensure compliance with all State Medicaid Rules and Regulations, staying up-to-date on updates to Federal and State rules and regulations.
  • Collaborate with Accounts Receivable and the Medicaid Controller/Analyst to track Medicaid issues with IGCP participants on a monthly basis.
  • Work with Enrollment Representatives to troubleshoot difficult cases and provide guidance on eligibility and classification issues.
Requirements
  • 3+ years of related experience
  • 1+ year of experience with CBMS Medicaid systems and knowledge of Medicaid system and benefits
  • High School diploma or GED
  • Valid state-issued driver's license, personal transportation, good driving record, and auto insurance
Preferred Qualifications
  • Bachelor's Degree
About InnovAge

InnovAge is dedicated to empowering seniors to live independently and age in their own homes and communities safely. We offer an alternative to nursing homes through our Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers.

We are committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. Our benefits package includes medical/dental/vision insurance, short and long-term disability, life insurance and AD&D, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays.



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