Medicaid Managed Care Liaison

FORESTDALE INC.•Town of Perinton, NY

About The Position

The Medicaid Managed Care Liaison (MMCL) organizes the exchange of health information, treatment planning, discharge planning, and documentation for cases assigned to him/her. This includes arranging for medical escorts, transportation and supervision to health care appointments in the community. This position maintains all clerical and clinical documentation in compliance with NY State and City regulations.

Requirements

Associate’s degree or higher required.
Knowledge of Medicaid billing processes
Proficient in Microsoft Office
Minimum of two years of work experience in billing and dealing with medical/ mental health claims.
Strong organizational, verbal and written communication skills
Ability to multitask
Compliance with:
Required background checks, including: NYS Statewide Central Register of Child Abuse/Maltreatment, NYS Sex Offender Registry, NYS Division of Criminal Justice Services fingerprinting, NYS Justice Center Staff Exclusion List, NYS OMIG Medicaid Exclusion List.
Mandated reporter training.
Applicable provisions of the NYS Education Law with respect to hiring and retaining of licensed professionals.

Responsibilities

Coordinating with the Managed Care Organizations (MCOs):
MCO enrollment, disenrollment, transitions
Completing transmittal forms and troubleshooting insurance issues
Managing insurance cards for all clients.
Assisting with Primary Care Provider changes
Seeking MCO approval for services ordered by court
MCO credentialing and recredentialing for the clinic and providers as needed.
Facilitation of a single case agreement when a child is placed outside of the MCO service area or provider network
Billing support for Article 29i and CFTSS services
Ensure claims are submitted correctly
Address billing errors as they may arise.
Invoicing and reconciliation as needed.
Administrative support of clinic functions
Document pertinent information in the EHR
Communicate with clients/ patients in regards to all insurance related issues.
Additional duties as assigned.