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Eligibility and Financial Redetermination Representative

2 months ago


San Bernardino, California, United States InnovAge Full time
Job Summary

We are seeking a highly skilled Eligibility and Financial Redetermination Representative to join our team at InnovAge. As a key member of our staff, you will be responsible for assisting participants and their families/caretakers in the annual redetermination process for Medicaid.

Key Responsibilities
  • Redetermination Process: Complete all re-determinations for InnovAge PACE participants assigned 30 days before case due date, monitor the Medicaid aging report, and work to clear aged items in a timely manner.
  • Communication: Communicate the policies and procedures of Long Term Medicaid, Spousal Impoverishment, and Trusts to participants in a way that is easily understood by participants, families, and caregivers.
  • Home Visits: Perform home visits and/or Day Center visits to complete all Medicaid redeterminations within required time frames in a manner that is most convenient and efficient for the participant.
  • Paperwork Assistance: Assist participants, families, and caretakers in completing necessary paperwork needed for Medicaid re-determination, including collaborating with county government technicians to assess additional documentation needed.
  • Documentation: Document work and outcomes in the Participant Tracking System Record of Contact Notes and in the department tracking model.
  • Case Load Management: Organize case load and working area in an efficient manner that allows information to be accessed when not available.
  • Disenrollment: Complete disenrollment forms for HMOs and forward to supervisor in a timely manner.
  • Housing Forms: Process participant/intake/social worker housing forms and complete new supporting housing forms for all RVs if there is a differential in income.
Requirements
  • Knowledge of Medicaid: Current knowledge of the Medicaid system/benefits in addition to community resources that are available to seniors and their families.
  • Education: High School diploma or GED required.
  • Driver's License: Requires a valid state-issued driver's license, personal transportation, good driving record, and auto insurance as required by law.
Preferred Qualifications
  • Language Skills: Bi-lingual.
About InnovAge

InnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. We offer an alternative to nursing homes through our Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. Our team members are our greatest asset and have a significant impact on the lives of our participants every day.

We are committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity/expression, national origin, disability, protected veteran status, pregnancy, or any other protected status.