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Medicaid Application Specialist

2 months ago

Garden City, New York, United States Med-Metrix Full time
Job Overview

Position Summary

The Medicaid Coordinator plays a crucial role in facilitating the Medicaid application process for patients associated with our healthcare partners, including both current and former patients. This position is essential in assisting patients with the necessary documentation and information required to secure Medicaid benefits, thereby ensuring timely reimbursement for our partner hospitals.

Key Responsibilities

  • Conduct phone interviews with patients to assess Medicaid eligibility based on referrals from healthcare facilities.
  • Assist patients in enrolling in health insurance programs through the Marketplace or by preparing and submitting paper applications to relevant agencies.
  • Handle and process sensitive patient information with confidentiality and care.
  • Utilize various resources, including online search tools and hospital databases, to verify and update patient contact details.
  • Investigate and resolve issues related to Medicaid applications and eligibility.
  • Generate and send automated correspondence to patients using the organization's database.
  • Request and obtain necessary third-party information from Medicaid Clerks and review submissions upon receipt.
  • Confirm insurance coverage for patients as needed.
  • Maintain accurate records of all actions taken on patient accounts in the internal database.
  • Monitor the status of Medicaid applications through the Marketplace and communicate with local agencies for updates.
  • Track and manage denied applications throughout the appeals process.
  • Prepare and analyze reports on outstanding accounts using Microsoft Excel.
  • Organize and schedule meetings with patients to discuss their applications.
  • Maintain and manage calendars effectively.
  • Respond to requests for additional documentation from relevant agencies.
  • Ensure compliance with HIPAA regulations regarding the handling of protected health information (PHI).

Qualifications

  • A High School Diploma or equivalent is mandatory.
  • Bilingual proficiency in English and Spanish is essential.
  • Familiarity with ePACES and LexisNexis is advantageous.
  • Previous experience in healthcare or insurance sectors is preferred.
  • Proficient in Microsoft Office Suite, particularly Excel, Word, and Outlook.
  • Strong communication skills for effective interaction with external parties.
  • Ability to navigate the internet and learn new database systems.
  • Excellent research and investigative skills.
  • Strong written and verbal communication abilities.
  • Prior administrative experience is required.
  • Capability to multitask efficiently.
  • Strong organizational skills are necessary.

Work Environment

  • Physical Requirements: The role may require occasional movement within the workspace, including sitting, performing manual tasks, and operating office equipment.
  • Mental Requirements: The position demands the ability to follow instructions, collaborate with colleagues, and manage stress effectively.
  • Work Setting: The typical noise level in the work environment is generally low.

Med-Metrix is committed to maintaining a diverse and inclusive workplace, ensuring equal opportunity for all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, or any other characteristic protected by law.