Medicaid Specialist

CareOne Group•Fort Lee, NJ

About The Position

The Medicaid Specialist is responsible for supporting multiple Care One centers within a designated region by completing and tracking pending Medicaid applications and redeterminations in order to ensure financial eligibility for the dates of service needed to secure valid Medicaid payer status. Medicaid Specialist will conduct interviews with patients/families/responsible parties to determine potential Medicaid program eligibility and will coordinate with the local Board of Social Services to complete the application process. Working knowledge of the New Jersey Medicaid application process and associated state regulations, customer service, documentation, client tracking and reporting are critical components of this position.

Requirements

Bachelor's degree preferred or equivalent work experience in long-term care industry revenue cycle management.
Working knowledge and understanding of New Jersey/Massachusett's Medicaid application process.
Strong communication, analytic and writing skills.
Ability to multi-task, handle multiple priorities and to work independently.
Computer proficiency.
Customer service skills.
Dependable transportation for field work.

Responsibilities

Provide efficient, timely and consumer friendly services to facilitate the Medicaid eligibility application and redetermination process.
Meet with families/responsible parties and determine and obtain information and documentation needed to complete the Medicaid application.
Schedule and attend Medicaid application interviews at local Board of Social Services location(s).
Regularly follow-up with local Board of Social Services to determine status of cases.
Monitor and track Medicaid and redetermination applications throughout the eligibility process and collect and maintain accurate Medicaid eligibility determination tracking logs.
Communicate timely to Center and Manager any potential problem cases or non-compliance by family/responsible parties.
Respond to case discontinuation and/ or denials by determining the action required which may include appeal, reapplication or acceptance.
Participate in center meetings as appropriate to facilitate and enhance the Medicaid eligibility determination process.