Manager, Medicaid Eligibility

Med-Metrix•Orlando, FL

2d•Onsite

About The Position

The Manager, Medicaid provides support and direction to the department’s team members. They will lead the division in determining Medicaid eligibility for patients of our client hospitals and in providing assistance to patients in completing the Medicaid application process. The Manager, Medicaid works under limited supervision. They must be able to identify issues that arise, determine the appropriate course of action, and communicate problems when necessary to management for further resolution. The Manager, Medicaid must perform all duties in accordance with HIPAA, the Firm’s and Medicaid guidelines at all times.

Requirements

Associates degree or higher required
Must have held a managerial position, preferably within the customer service field for at least 3 years with the ability to supervise others
Proficient in Microsoft Office applications (Excel, Word and Outlook)
Good planning and implementation skills
Strong investigatory, researching and problem-solving skills
Excellent written and verbal skills
Must have administrative experience
Ability to efficiently multitask
Possess a high level of organization skills and be detail-oriented

Nice To Haves

Experience with ePACES and LexisNexis is a plus
Bilingual English/Spanish preferred
Be able to effectively communicate with third parties

Responsibilities

Confirm patients’ eligibility for Medicaid by reviewing account notes in the department’s proprietary database
Review completed applications to expedite the submission process
Draft submission letters, emails and texts
Post approval, review submission to make sure that all protocols were properly followed
Track deadlines using Excel
Create and review various reports on a continual basis
Access hospital databases to obtain information needed for claims and reporting
Communicate with the Department of Social Services to address any concerns or questions in relation to any submissions
Review cases in the database to ensure statuses are up to date and accurate
Deliver continual feedback to management for on-going processes and workflow improvement
Request changes to workflow based on business needs with IT
Assist in the development of protocols
Prepare cases to be closed and notify the appropriate team members of their closing
Responsible for the maintaining of the department’s allocated budget
Coordinate team meetings and arrange any team events
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards