Medicaid Specialist

St Camillus Residential Health•Syracuse, NY

5d•$22 - $26•Onsite

About The Position

St. Camillus is seeking a Full Time Medicaid Specialist to join their Patient Financial Services Team. This role is responsible for working with various departments and residents/family members to manage Medicaid eligibility and billing processes within a skilled nursing facility setting.

Requirements

Associate’s Degree
Experience in Medicaid Eligibility and/or Skilled Nursing Facility Medicaid billing.
Strong Microsoft office experience (Word and Excel)
Strong verbal, written, computer and leadership skills are required.
Must be a team player and be able to build strong relationships with residents and their families.
Must be able to work independently managing multiple projects at once.
Must be knowledgeable of the most current Medicaid regulations and the Medicaid application process.
Must ensure all required documentation is obtained from the family or work with their financial institution, etc. to obtain the information on their behalf.

Responsibilities

Review insurance coverage with families to determine financial liability and/or need for Medicaid.
Determine estimated Net Available Monthly Income (NAMI).
Complete, monitor, and ensure timely submission of Medicaid applications and recertification’s.
Maintain knowledge of third party billing regulations.
Assist with day-to-day billing functions as needed.
Track Medicaid application submission deadlines and status.
Communicate with local DSS office, St. Camillus staff, and residents/family members for timely approval and cash flow.
Obtain required documentation from families or financial institutions.
Complete and submit required Medicaid forms and documents (e.g., LDSS 3559s, Nursing Home Account Sheets, PRIs).
Maintain accurate records of member’s eligibility status, recertification dates, and MLTC provider.
Be knowledgeable on general skilled nursing facility payers and billing procedures.
Utilize financial reports to follow Private accounts that may need Medicaid.
Enter approved Medicaid application information into the billing system.
Report Medicaid application issues to the PFS Manager, Director of Finance, and VP of Finance.
Provide written referral and backup documentation on Medicaid cases requiring attorney involvement.
Assist with any financial audits initiated by outside agencies (e.g., OMIG, Social Security).
Support department Manager, Director of Finance, and VP of Finance with required tasks.
Responsible for employee injury prevention, follows safety rules and addresses safety issues with supervisor.
Perform other duties as assigned by supervisor.