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Medicaid Services Specialist
2 months ago
The Yukon-Kuskokwim Health Corporation is dedicated to enhancing the health of our community. We are a Tribal health care organization committed to serving a diverse population across rural Alaska.
Role Summary:
The Medicaid Services Specialist I operates under general supervision to facilitate transportation and logistical support for Medicaid recipients. This role involves assessing medical necessity and documenting findings through appropriate systems.
Key Responsibilities:
- Collaborate with clinical providers to verify medical necessity for transportation services.
- Act as a liaison between the organization and the State of Alaska regarding Medicaid Transportation Services.
- Collect and organize necessary information for prior authorization requests, ensuring timely processing.
- Guide patients on eligibility issues and refer them to appropriate departments as needed.
- Review documentation to substantiate medical necessity for travel authorizations.
- Coordinate with various units to resolve provider and claims inquiries.
- Submit claims and adjustments through electronic and paper formats.
- Maintain accurate records of issues encountered and actions taken.
- Engage with state entities to address provider claims effectively.
- Assist in coordinating lodging and travel needs for customers.
Qualifications:
High school diploma or equivalent required. Proficiency in computer systems is essential. Candidates should possess:
- Two years of clerical and customer service experience.
- Basic computer and Excel skills.
- Strong attention to detail and accuracy in data entry.
- Excellent communication skills, both written and verbal.
Benefits:
We offer a comprehensive benefits package including generous paid time off, healthcare coverage, life and disability insurance, and retirement plans. The Yukon-Kuskokwim Health Corporation is an Affirmative Action/Equal Opportunity Employer, ensuring all qualified individuals receive consideration for employment without discrimination.
