Medicaid Specialist

The Medicaid Specialist is responsible for ensuring timely and accurate completion and review of Medicaid Pending applications. This includes gathering all required documentation and ensuring compliance with Federal, State, and local standards, guidelines, and regulations.

CSSCM is seeking a full-time Medicaid Specialist to join our team. As a Medicaid Specialist, you will work collaboratively with clients, responsible parties, and families to ensure the Medicaid Application process starts within 24-48 hours of admission.

Key Responsibilities:

• Works one on one with clients, responsible parties, and families to ensure the Medicaid Application process starts within 24-48 hours of admission.
• Educates clients, responsible parties, and families in the Medicaid Process and communicates documents required to complete the Medicaid Application.
• Ensures complete confidentiality of financial, HIPAA protected information of clients.
• Responsible for the completion of the Options package for Aging and Adult Services for the clinical approval of Medicaid.
• Responsible for ensuring Spousal cases include the additional information required by the County to ensure a timely process and approval of a Medicaid Application.
• Responsible to ensure the resident and/or responsible party or family member understands and signs the Patient Liability which is due on a monthly basis.
• Responsible to keep and update the Medicaid Pending log on a daily basis.
• Works collaboratively with the applicable County office to ensure they have all required documentation.
• Responsible to attend face-to-face interviews at the County Assistance Office in order to secure a grant if families are uncooperative or unable to attend.
• Responsible for ensuring the County Assistance Office is in receipt of all verifications.
• Responsible for ALL active in-house Medicaid clients' yearly recertifications.
• Complies with Health Insurance Portability and Accountability Act (HIPAA) regulations.

Qualifications:

• Must have ten plus years of work experience in Long Term Care. Proficient in the ICP Medicaid application process.
• Must be efficient, maintain confidentiality, exhibit good judgment, and have the ability to speak and write effectively.
• Must possess good communication and people skills.
• Must be knowledgeable of all Medicaid legal regulations, guidelines, and best practices.
• Must understand the basics of working in the business office and importance of following established processes.
• Must possess an aptitude for problem solving.
• Employment is contingent on completion of all pre-employment screenings, inclusive of criminal background check and Medicaid Exclusion Screening, both indicating negative results.