Medicaid Liaison

Cuyahoga County Board of Developmental Disabilities•Cleveland, OH

9h•$47,000 - $75,200•Hybrid

About The Position

The Cuyahoga County Board of Developmental Disabilities (Cuyahoga DD) is seeking a Liaison to expedite the process of establishing Medicaid eligibility in order to enroll individuals in Home and Community-Based Services (HCBS) waivers; assists with maintenance of Medicaid eligibility through Medicaid and HCBS redetermination processes. The nature of work will include but is not limited to the following: Maintain daily communication and consultation with the Specialized Medicaid Benefits Center (SMBC) staff, Community Medicaid Caseworkers, and Support Administrators regarding scheduled appointments, required verifications to complete eligibility, and results of initial and renewals interviews for waiver applicants/enrollees. Respond to a high volume of phone calls and emails from Cuyahoga DD and SMBC staff, walk-ins from providers, payees, and individuals/guardians regarding Medicaid eligibility, scheduled or missed interview appointments with SMBC, Medicaid verification, and other concerns for recommendation or resolution. Coordinate and collect applicable forms for initial Medicaid enrollment, SNAP benefit, and renewals from Cuyahoga DD staff, individuals/guardians, payees, and providers to submit to SMBC. Review applications and communicate with Cuyahoga DD staff regarding errors and required corrections for Medicaid enrollment. Act as Authorized Representative for Cuyahoga DD on behalf of individuals needing this service. On behalf of services include: receiving and processing JFS and ODM notices, gathering additional required verifications to complete initial and renewal packets, maintaining a log to track case specific communication, scanning submitted verifications to SMBC into OnBase, and attending interviews and Medicaid hearings. Work closely with SMBC to problem solve and resolve data discrepancies, PLOMS, billing, and level of care issues. Expedite pending Medicaid eligibility for waiver applicants and communicate as necessary with Cuyahoga DD staff. Use read-only access to Medicaid Programs (e.g. AEFMI and MITS) to verify eligibility for individuals on Medicaid, Social Security, Medicare, and other active Medicaid Benefits (e.g. HCBS, OHCW, RSS, SNAP, and Passport). Review documents and respond to general questions related to Social Security and Medicare benefits. Provide technical assistance to CMS staff, individuals, and authorized representatives regarding Medicaid documents and billing issues. Analyze MITS information to diagnose and resolve billing issues for individuals on waivers or in Intermediate Care Facilities. Maintain a high volume of data in Cuyahoga DD’s OnBase and Gatekeeper software packages pertaining to Medicaid enrollment. Report and verify changes in demographic, employment wages, and county to county transfers to SMBC/CDJFS to maintain benefits. Attend meetings as needed with Cuyahoga DD staff, providers, payees, and individuals/guardians at Cuyahoga DD, SMBC, or CDJFS offices. Perform Medicaid Administrative Claiming (MAC) activities that are applicable to this position, and are required by Waiver rules, policies and procedures. Position functions will be 100% MAC billable in a manner consistent with requirements of DODD and ODM. PERSONAL CONTACT: Frequent personal contact, telephone calls and written communications with Cuyahoga DD staff, individuals, families, community agencies and other state/county agencies.

Requirements

High school diploma required.
Valid state of Ohio driver's license and continued maintenance of excellent driving record.

Nice To Haves

Two years’ work experience with CRIS-E system, MITS, and Medicaid eligibility process preferred.
Two years’ work experience with HCBS waiver programs is preferred.
Two years successful work experience with programs for persons with DD is desirable.

Responsibilities

Maintain daily communication and consultation with the Specialized Medicaid Benefits Center (SMBC) staff, Community Medicaid Caseworkers, and Support Administrators regarding scheduled appointments, required verifications to complete eligibility, and results of initial and renewals interviews for waiver applicants/enrollees.
Respond to a high volume of phone calls and emails from Cuyahoga DD and SMBC staff, walk-ins from providers, payees, and individuals/guardians regarding Medicaid eligibility, scheduled or missed interview appointments with SMBC, Medicaid verification, and other concerns for recommendation or resolution.
Coordinate and collect applicable forms for initial Medicaid enrollment, SNAP benefit, and renewals from Cuyahoga DD staff, individuals/guardians, payees, and providers to submit to SMBC.
Review applications and communicate with Cuyahoga DD staff regarding errors and required corrections for Medicaid enrollment.
Act as Authorized Representative for Cuyahoga DD on behalf of individuals needing this service. On behalf of services include: receiving and processing JFS and ODM notices, gathering additional required verifications to complete initial and renewal packets, maintaining a log to track case specific communication, scanning submitted verifications to SMBC into OnBase, and attending interviews and Medicaid hearings.
Work closely with SMBC to problem solve and resolve data discrepancies, PLOMS, billing, and level of care issues.
Expedite pending Medicaid eligibility for waiver applicants and communicate as necessary with Cuyahoga DD staff.
Use read-only access to Medicaid Programs (e.g. AEFMI and MITS) to verify eligibility for individuals on Medicaid, Social Security, Medicare, and other active Medicaid Benefits (e.g. HCBS, OHCW, RSS, SNAP, and Passport).
Review documents and respond to general questions related to Social Security and Medicare benefits.
Provide technical assistance to CMS staff, individuals, and authorized representatives regarding Medicaid documents and billing issues.
Analyze MITS information to diagnose and resolve billing issues for individuals on waivers or in Intermediate Care Facilities.
Maintain a high volume of data in Cuyahoga DD’s OnBase and Gatekeeper software packages pertaining to Medicaid enrollment.
Report and verify changes in demographic, employment wages, and county to county transfers to SMBC/CDJFS to maintain benefits.
Attend meetings as needed with Cuyahoga DD staff, providers, payees, and individuals/guardians at Cuyahoga DD, SMBC, or CDJFS offices.
Perform Medicaid Administrative Claiming (MAC) activities that are applicable to this position, and are required by Waiver rules, policies and procedures.
Position functions will be 100% MAC billable in a manner consistent with requirements of DODD and ODM.
Frequent personal contact, telephone calls and written communications with Cuyahoga DD staff, individuals, families, community agencies and other state/county agencies.