Florida Medicaid Specialist (case manager 1)-PACE Program

Chapters Health System

2d•$20 - $28

About The Position

It’s inspiring to work with a company where people truly BELIEVE in what they’re doing! When you become part of the Chapters Health Team, you’ll realize it’s more than a job. It’s a mission. We’re committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success! Role: The Medicaid Eligibility Specialist performs verification of benefits and obtains authorizations in accordance with all state, federal and third party payor contractual requirements.

Requirements

High School Diploma or GED
Minimum of one (1) year of medical billing and collection or office experience
Employees working at PACE, certification of completion of Alzheimer's Disease and Related Dementias Training through the Florida Department of Elder Affairs.
Ability to prioritize and multi-task independently with little guidance
Must be self-motivated and service oriented
Excellent written and verbal communication skills
Accurate typing and data entry skills
Satisfactorily complete competency requirements for this position.

Nice To Haves

Knowledge of third party billing and state and federal collection regulations preferred

Responsibilities

Scans admissions for patients without insurance and files Medicaid applications
Coordinates with families, social workers, patients, etc.
Performs insurance benefit verification for all payors.
Obtains authorization as required by plan benefit.
Processes incoming correspondence from payors.
Resolves any issues with coverage and escalates complicated issues to the Supervisor.
Ensures timely, complete and accurate processing of benefit information.
Prepares monthly nursing home room and board invoices.
Collaborates with Medicaid Eligibility Vendor to obtain Medicaid eligibility.
Obtains patient responsibility payment as needed.
Performs other duties as assigned.
Represent the Company professionally at all times through care delivered and/or services provided to all clients.
Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse.
Comply with Company policies, procedures and standard practices.
Observe the Company's health, safety and security practices.
Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company.
Use resources in a fiscally responsible manner.
Promote the Company through participation in community and professional organizations.
Participate proactively in improving performance at the organizational, departmental and individual levels.
Improve own professional knowledge and skill level.
Advanced electronic media skills.
Support Company research and educational activities.
Share expertise with co-workers both formally and informally.
Participate in Quality Assessment and Performance Improvement activities as appropriate for the position.