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Insurance Specialist
2 months ago
Under the supervision of the Business Operations Manager, the Insurance Specialist - Medicaid Coordinator is responsible for assisting participants and families in the application process for Medicaid. This role requires a high level of expertise in Medicaid rules and regulations, as well as excellent communication and customer service skills.
Key Responsibilities- Assist participants and families in completing Medicaid applications, ensuring eligibility for enrollment.
- Maintain a log of Medicaid eligibility and work closely with Marketing and Enrollment Specialists to ensure Medicaid payment for eligible participants.
- Provide support and backup to the Enrollment Specialist with regards to Medicaid operations, resolving difficult cases and working with Medicaid staff to ensure timely approval of cases.
- Develop and maintain working relationships with county technicians, providing additional information as needed to ensure timely approval of cases.
- Stay up-to-date on current Medicaid rules and regulations, communicating confidently with family members and participants on these regulations.
- Maintain a good working knowledge of Straight Medicaid, LTC Medicaid, Spousal Impoverishment, and Trusts.
- Responsible for completing disenrollment forms for HMOs and submitting them to the supervisor.
- Participate in community committees as a representative of the organization.
- Follow all Policies and Procedures, OSHA safety guidelines, and maintain the confidentiality of company procedures, results, and information about participants, clients, or families.
- Handle potentially infectious specimens with appropriate biohazard precautions and practice Universal Precautions.
- Maintain a courteous, helpful, and professional behavior on the job, displaying a willingness and ability to be responsive in a warm and caring manner to all customer groups.
- Maintain a safe working environment, following Safety Policies and Procedures.
- Participate in continuing education classes and required staff and training meetings, maintaining professional affiliations and certifications.
- Perform other duties as required or requested in a positive and helpful manner to ensure a smooth-running work area.
- Knowledge of Medicaid system and benefits.
- High school diploma required.
- Reliable transportation, a valid driver's license, and minimum state required liability auto insurance.
- Medically cleared for communicable diseases and up-to-date immunizations before engaging in direct participant contact.
- Pass a comprehensive criminal background check, including federal and state Medicare/Medicaid exclusion lists, criminal history, education verification, license verification, reference check, and drug screen.
