Medicaid Application Specialist

3 weeks ago


Maitland, Florida, United States Compass Senior Solutions Care Manag Full time
Job Summary

We are seeking a highly skilled Medicaid Specialist to join our team at Compass Senior Solutions Care Management. As a Medicaid Specialist, you will play a critical role in ensuring the timely and accurate completion of Medicaid applications, ensuring compliance with federal, state, and local regulations, and providing exceptional customer service to our clients.

Key Responsibilities
  • Work closely with clients, responsible parties, and families to initiate the Medicaid application process within 24-48 hours of admission for Medicaid pending cases.
  • Provide education and support to clients, responsible parties, and families on the Medicaid application process, including required documentation.
  • Notify the Business Office Manager promptly if there is no cooperation or delay in cooperation from clients, responsible parties, or families in the Medicaid application process.
  • Maintain confidentiality of financial and HIPAA-protected information of clients.
  • Complete the Options package for Aging and Adult Services for clinical approval of Medicaid.
  • Ensure spousal cases include additional required information by the County for timely processing and approval of Medicaid applications.
  • Responsible for ensuring residents and/or responsible parties or family members understand and sign the Patient Liability, which is due on a monthly basis.
  • Update the Medicaid Pending log on a daily basis.
  • Collaborate with the applicable County office to ensure they have all required documentation.
  • Attend face-to-face interviews at the County Assistance Office to secure a grant if families are uncooperative or unable to attend.
  • Ensure the County Assistance Office receives all verifications.
  • Responsible for all active in-house Medicaid clients' yearly recertifications.
  • Comply with Health Insurance Portability and Accountability Act (HIPAA) regulations.
Requirements
  • 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, including a criminal background check and Medicaid Exclusion Screening, both indicating negative results.

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