Medicaid Application Specialist

2 weeks 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, ensuring that both current and former patients receive the necessary support. This position involves gathering and processing essential information from patients to expedite their Medicaid applications, thereby ensuring timely reimbursement for our affiliated hospitals.

Key Responsibilities

  • Conduct phone screenings to assess Medicaid eligibility for patients referred by partner hospitals.
  • Assist patients in enrolling in health insurance plans through the Marketplace or by completing necessary paper applications for submission to local service departments.
  • Handle and validate sensitive patient information with the utmost confidentiality.
  • Utilize various resources to verify and update patient contact details.
  • Investigate and resolve any issues related to Medicaid applications.
  • Generate and send automated correspondence to patients using the firm’s database.
  • Access and retrieve data from hospital information systems.
  • Request third-party information from the Medicaid Clerk and review it upon receipt.
  • Confirm insurance coverage for patients.
  • Maintain accurate records of all actions taken on patient accounts in the internal database.
  • Monitor the status of applications through the Marketplace and communicate with local departments for updates.
  • Track denied applications and assist throughout the Fair Hearing process.
  • Compile and analyze reports on active accounts using Microsoft Excel.
  • Organize and coordinate meetings with patients as needed.
  • Manage scheduling and calendar activities.
  • 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.
  • Prior 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 third parties.
  • Ability to navigate the internet and learn new database systems.
  • Exceptional research and investigative skills.
  • Excellent written and verbal communication abilities.
  • Administrative experience is required.
  • Capability to manage multiple tasks efficiently.
  • Strong organizational skills are necessary.

Work Environment

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

Med-Metrix is committed to maintaining a diverse and inclusive workplace and does not discriminate against any employee or applicant based on various protected characteristics.

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