Medicaid Eligibility Specialist

4 weeks ago


Carrollton, Texas, United States Cantex Continuing Care Network Full time
Job Summary:

The Medicaid Eligibility Specialist is responsible for assisting with the pre-screening process and eligibility planning for post-acute and long-term care patients at Cantex Continuing Care Network. This role ensures that all necessary applicant pre-screening is completed correctly and timely prior to admission or payer change, and that company policy is followed to ensure the eligibility process is successful.

Key Responsibilities:
  • Verify information with residents and/or their authorized representative, collateral sources, and Cantex CC admission and finance office team members.
  • Serve as a resource for patients and Cantex CC regarding Medicaid eligibility guidelines.
  • Execute the proper internal documents required for compliance with the eligibility process.
  • Verify case data, and financial plan and assist in resolving application outstanding items.
  • Accurate data entry of case information in the tracking tool system.
  • Perform and track Medicaid integrity audits, reviews, and escalation requests.
  • Submit and retrieve eligibility requests through the TMHP Medicaid/MCO Portals.
  • Prompt communication with the Medicaid Eligibility Manager and appropriate stakeholders of any areas of concern.

What We Offer:

Cantex Continuing Care Network is an equal opportunity employer and offers an excellent benefits package, including 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance plans, as well as a highly competitive compensation package. We are committed to a culture that respects our differences and values the contributions of all people.

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