Affordable Care Act Coordinator

Join YesCare: A Career with Purpose in Correctional Healthcare

Correctional healthcare is more than just a job—it's a calling. At YesCare, you have the unique opportunity to make a meaningful difference in the health, well-being, and future of an underserved population.

As a pioneer in correctional healthcare services, YesCare is committed to innovation, clinical expertise, and compassionate care. By choosing a career with YesCare, you are opting for professional growth, impactful work, and the chance to be part of a legacy of excellence. You'll have access to the resources, training, and support needed to enhance your skills and reach your full career potential. Your role at YesCare allows you to contribute directly to the care and well-being of patients who need it most. Join a team that's known for its innovative approaches and dedication to improving correctional healthcare.

Make a difference where it matters most. Start your journey with YesCare today and be part of a team that is transforming lives through care and expertise.

Key Responsibilities

• Medicaid Eligibility & Coverage Coordination:
• Submit inmate applications to Medicaid outpost workers for eligibility determination and track the status to completion.
• Input Medicaid coverage details into the YesCare transactional system upon approval to ensure accurate Coordination of Benefits (COB) on inpatient claims.
• Coordination of Benefits (COB):
• Work closely with Intake Coordinators and custody staff to determine if other insurance coverage exists at intake or during sick calls for existing inmates.
• Collaborate with the COB Coordinator to search alternative coverage databases when current coverage details are unavailable.
• Tracking & Reporting:
• Monitor Medicaid eligibility denials and follow up when additional services are utilized to ensure continued eligibility.
• Ensure that notices of coverage are sent to hospitals upon inmate admission for accurate billing information.
• Billing and Repricing:
• Submit bills for repricing and confirm receipt of bills from healthcare providers to ensure timely payment.

Key Qualification

• Experience:
• 2+ years of experience working in a physician's office or with medical records management.
• Strong knowledge of Coordination of Benefit (COB) provisions in commercial, Medicaid, or Medicare environments.
• Proficient understanding of ICD-9, HCPCS, CPT, and revenue coding systems.
• Demonstrated ability to recognize and interpret insurance carrier EOBs (Explanation of Benefits) and plan documents.
• Education/Certifications:
• Certification in a relevant field or equivalent experience in a healthcare setting.
• Skills:
• Strong knowledge of current medical terminology and insurance processes.
• Ability to interact effectively with clinicians, office staff, utilization review teams, and other departments (e.g., customer service, finance, provider operations).
• Proven organizational and prioritization skills with a commitment to delivering quality services and maintaining customer satisfaction.
• Excellent problem-solving and critical thinking skills in a healthcare environment.
• Compliance:
• Must undergo background check, security clearance, and drug screening.

YesCare Benefits (Available for Full-Time Positions):

• Health, Dental, and Vision Insurance
• Life and Disability Insurance
• Generous PTO Plan
• 401k with Matching Contributions
• Employee Discount and Rewards Program
• Tuition Assistance
• Continuing Education Reimbursement

Why Join YesCare?

YesCare provides a supportive and structured environment where you can thrive in a leadership role while delivering meaningful healthcare in a correctional setting. Your expertise and leadership will directly impact the quality of care and operations within our facilities.

Equal Opportunity Employer Statement

YesCare is an Equal Opportunity/Affirmative Action Employer. We comply with all federal and state employment opportunity laws and consider qualified applicants without regard to race, gender, national origin, religion, age, sexual orientation, disability, or veteran status.