Child Medicaid Coordinator

CHILDRENS NETWORK OF SOUTHWEST FLORIDA LLC•Fort Myers, FL

10d•$20 - $0•Onsite

About The Position

This is supervised office-based work in the Children’s Network of SWFL’s Revenue Maximization unit requiring a working knowledge of Medicaid managed care plan enrollment and benefits. Tasks for this position include timely enrollment onto the appropriate Medicaid managed care plan for children entering the child welfare system, assisting with Primary Care Physician (PCP) changes, dental and medical plan changes and processing incoming Medicaid mail. These responsibilities require professional interaction with case managers, caregivers, medical and dental offices, Medicaid plan staff, and other stakeholders providing exceptional customer service, support and assistance. The Child Medicaid Coordinator must acquire the skills to become proficient with several statewide management information systems including FSFN, FLORIDA, and FLMMIS and must gain familiarity of the Florida child welfare system.

Requirements

High School diploma or equivalent and at least 2 years of related work experience; or Associate’s Degree from an accredited college, university, or technical school and 1 yr. related experience.
Official transcripts are a mandatory requirement
Must be able to operate standard modern office machinery, including fax, telephone, calculator, computer, scanner, printer, copier, and mail machine.
Minimum typing speed of 45 wpm; excellent word processing skills.
Must be competent with Microsoft Office Suite programs, including Word, Excel, and Outlook.
Must be competent with basic e-mail protocol and procedures including sending, receiving, replying, attachments, and meeting scheduling.
Must possess excellent organizational skills and abide by the highest standards of confidentiality.
Must communicate effectively and have excellent customer service skills.
Valid driver’s license required, with a clean driver’s license check, and proof of insurance
Criminal background screening (fingerprinting) (Local Law Enforcement and FBI/FDLE), and Abuse Registry Check
Drug Screening is a requirement
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to write reports, business correspondence, and procedure manuals.
Ability to effectively present information and respond to questions, common inquiries, or complaints from groups of managers, clients, customers, and the public.
Ability to speak effectively before groups of customers or employees.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rate, ratio, percentages, ability to draw and interpret bar graphs.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
Ability to be proactive, as well as handle problems involving several concrete variables in standardized situations.
Ability to define problems, collect data, establish facts, and draw valid conclusions.
Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Ability to sit for extended periods; walk; stand; use hands to finger, handle or feel; reach with hands and arms; stoop, kneel or crouch; talk and hear.
Visual acuity sufficient to read and operate standard modern office machines.
Normal or corrected normal vision for reading documents and computer screens.

Nice To Haves

Prefer experience working with Medicaid health plans.
Medical office or pharmacy experience a plus.

Responsibilities

Assist case managers, foster parents, caregivers and doctors’ offices with Medicaid questions or issues of access to Medicaid services.
Provide timely and thorough review of all mail from AHCA ensuring all notices are responded to appropriately to avoid any lapse in coverage.
If a lapse in coverage does occur, work with the Rev Max Specialist to reinstate benefits promptly and assist case manager or caregiver as requested to ensure the child continues to receive services as needed.
Review and maintain all Medicaid and medical related correspondence.
Review medical bills and research coverage before forwarding to Utilization Management Unit.
Coordinate distribution of all member ID cards, handbook or other notifications to case managers as received by the Lead Agency.
Complete necessary Primary Care Physician (PCP) changes to ensure children receive appropriate medical care.
Communicate with medical offices to coordinate timely appointments, as necessary.
Make a health care plan selection within the month the notification that a selection (Choice) can be made.
Utilize the Evolve client portal, FLMMIS, and FLORIDA system to access necessary information and review account information.
Provide education on the benefits and expanded benefits of the child welfare specialist plan.
Maintain relationships with insurance company representatives and provide necessary documents for change requests.
Assist in Scanning of appropriated documents including Member Identification Health Plan Card
Attends and successfully completes all mandated training courses within the probationary period, and as scheduled thereafter.
Other duties may be assigned as special projects may be requested.