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Medicaid Managed Care Liaison
2 months ago
Berkshire Farm Center & Services for Youth is seeking a highly skilled Medicaid Managed Care Liaison to join our team. As a key member of our organization, you will play a critical role in ensuring seamless coordination of care with internal and external stakeholders, while ensuring access to healthcare for youth and families.
Key Responsibilities- Primary Point of Contact: Serve as the primary point of contact for the Medicaid Managed Care Plan, handling tasks such as enrollment/disenrollment, transitions, notifications, prior authorizations, concurrent reviews, replacement insurance cards, consent and/or confidentiality issues.
- Communication and Collaboration: Communicate effectively with clinical and billing staff in a timely manner regarding consent, claims issues, and other activities related to enrollment and other issues.
- Insurance Claims Review: Possess the ability to review and understand insurance claims.
- Coordination with Medicaid Plans: Coordinate with the Medicaid Managed Care Plans' Foster Care Coordinator.
- Primary Care Provider Changes: Inform and coordinate with Medicaid Managed Care Plan when a child's primary care provider needs to be changed.
- Foster Care Placement Changes: Support with foster care placement changes, including access to healthcare services.
- Single Case Agreements: Assist with facilitating a single case agreement when a child is placed outside of the Medicaid Managed Care Plan's service area or provider network.
- Healthcare Provider Selection: Coordinate with healthcare providers in the selection and referral of medical care programs and health services, including school and community-based programs.
- Education: High School Diploma or GED required; Associates Degree strongly preferred.
- Experience: Minimum 1 year of experience as a Patient Account Representative, Health Information Clerk, Medical Records Analyst, or other related field required.
- Skills: Experience with electronic health record databases and insurance portal(s), proficiency in Microsoft Applications (Excel, Word, Outlook), and ability to conduct independent research.
- Communication and Confidentiality: Strong communication skills required, with the ability to communicate professionally both verbally and written with community partners, stakeholders, clients, and providers. Demonstrated ability to handle confidential and sensitive information with extreme discretion, with knowledge of HIPAA regulations.
- Additional Requirements: 2 years of experience with medical coding and billing review strongly preferred. Must have a current, valid driver's license. Ability to work with economically and culturally diverse populations.
