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Medicaid Support Specialist

2 months ago

Daytona Beach, Florida, United States HealthFund Solutions LLC Full time
Job Overview

At HealthFund Solutions LLC, we are dedicated advocates for uninsured individuals and collaborative partners to healthcare institutions. With extensive experience in the healthcare sector, we have identified an increasing necessity to assist a growing segment of the population lacking health insurance. Through our various programs, including Medicaid screenings and premium monitoring, we empower patients to secure the healthcare coverage they require to regain their health and stability.

Position Summary: Reporting to the Regional/Eligibility Manager, the Medicaid and Disability Caseworker will oversee activities to guarantee that patients receive appropriate funding for healthcare services through Medicaid, Social Security, County Indigent, or other qualifying programs. This role involves guiding patients and their families in completing necessary forms, applications, and documentation. Caseworkers will conduct screenings via phone or mail to assess eligibility for Federal, State, and County programs, including Medicaid, Disability, and ACA Marketplace Insurance. This is a part-time onsite role supporting a Medical Center, requiring weekend availability (Saturday and Sunday) with a minimum commitment of two weekends per month, ideally three to four weekends monthly.

Preferred Qualifications:

  • Familiarity with Florida Medicaid, Disability, or DCF is advantageous.

Key Responsibilities:

  • Conduct daily eligibility screenings via phone or mail.
  • Make appropriate referrals to Sponsorship programs.
  • Complete and submit necessary applications.
  • Follow up on previously submitted applications until a decision is reached.
  • Gather all required documentation.
  • Submit essential paperwork.
  • Request and file hearings as necessary.
  • Maintain communication with patients and hospital personnel.
  • Review patient information to assess eligibility.
  • Prepare and verify documents for accuracy and completeness.
  • Provide technical assistance regarding various programs offered by HFS.
  • Manage and organize case files.
  • Maintain databases and generate required reports.
  • Foster professional relationships with HFS and hospital staff.
  • Scrub secondary accounts based on contract stipulations.
  • Update insurance information in hospital systems for billing purposes.
  • Availability for evening, weekend, and holiday shifts may be required.
  • Perform additional duties as assigned by management.

Requirements:

  • High school diploma required; Associate's degree preferred.
  • Comprehensive understanding of Florida Medicaid eligibility criteria.
  • Experience with full-cycle Florida Medicaid applications is preferred.
  • Experience with Disability applications for both Medicaid and Social Security is beneficial.
  • Ability to maintain confidentiality and adhere to HIPAA regulations.
  • Strong communication, organizational, and time management skills.
  • Self-directed work ethic.
  • Effective stress management abilities.
  • Bilingual in Spanish is preferred.
  • Clear and concise communication skills are essential.
  • Excellent verbal and written communication capabilities.
  • Must possess a valid driver's license with a clean driving record and active auto insurance.
  • Remote/Hybrid Work: If required to work from home, a minimum internet speed of 75Mbps and a reliable cellular signal are necessary for effective job performance.

Physical Requirements:

  • Ability to sit for extended periods while entering data into a computer.
  • Capability to occasionally lift up to 10 pounds.
  • Ability to maintain focus and concentration for prolonged periods.

Note: This job description is not exhaustive. Employees may be required to perform other duties to meet the organization's ongoing needs.

HealthFund Solutions LLC is an equal opportunity employer, considering all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

Successful candidates will be required to complete Form I-9, with information verified through the E-Verify system, operated by the Department of Homeland Security in partnership with the Social Security Administration.

All candidates offered a position must pass pre-employment screenings, including a national background check and a 12-panel drug screen.

HealthFund Solutions LLC maintains a Drug-Free Workplace.