Eligibility & Financial Redetermination Rep
About The Position
The Eligibility & Financial Redetermination Representative is responsible for assisting participants and their families/ caretaker(s) in the annual redetermination process for Medicaid which includes the process of obtaining documentation, providing participants with resources and assisting in necessary paperwork/documentation of all necessary forms. Completes all re-determinations for InnovAge PACE participants assigned 30 days before case due date. Monitors the Medicaid aging report and works to clear aged items in a timely manner. Communicates 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 caregiver(s). Performs 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. Assists participants, families and caretaker(s) in completing necessary paperwork needed for Medicaid re-determination including collaborating with county government technicians to assess additional documentation needed. Documents work and outcomes in the Participant Tracking System Record of Contact Notes and in the department tracking model. Organizes case load and working area in an efficient manner that allows information to be accessed when not available. Completes disenrollment forms for HMO’s and forward to supervisor in a timely manner. Processes participant/Intake/social worker housing forms and completes new supporting housing forms for all RV’s if there is a differential in income.
Requirements
- Current knowledge of the Medicaid system/benefits in addition to community resources that are available to seniors and their families.
- High School diploma or GED required.
- Requires a valid state issued driver’s license, personal transportation, good driving record and auto insurance as required by law
Nice To Haves
- Bi-lingual
Responsibilities
- Assisting participants and their families/ caretaker(s) in the annual redetermination process for Medicaid
- Obtaining documentation
- Providing participants with resources
- Assisting in necessary paperwork/documentation of all necessary forms
- Completes all re-determinations for InnovAge PACE participants assigned 30 days before case due date
- Monitors the Medicaid aging report and works to clear aged items in a timely manner
- Communicates 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 caregiver(s)
- Performs 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
- Assists participants, families and caretaker(s) in completing necessary paperwork needed for Medicaid re-determination including collaborating with county government technicians to assess additional documentation needed
- Documents work and outcomes in the Participant Tracking System Record of Contact Notes and in the department tracking model
- Organizes case load and working area in an efficient manner that allows information to be accessed when not available
- Completes disenrollment forms for HMO’s and forward to supervisor in a timely manner
- Processes participant/Intake/social worker housing forms and completes new supporting housing forms for all RV’s if there is a differential in income
Benefits
- medical/dental/vision insurance
- short and long-term disability
- life insurance and AD&D
- supplemental life insurance
- flexible spending accounts
- 401(k) savings
- paid time off
- company-paid holidays
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
