Medicaid Specialist

Entyre Inc • Arlington, VA

24d

About The Position

At Entyre Care, our mission is to support caregivers by offering families both emotional and financial support throughout their caregiving journey. We ensure our caregivers have access to the right resources and guidance in all areas of outpatient care, so they feel confident and prepared to care for their loved ones at home. Entyre Care recognizes the essential role caregivers play and are committed to helping them receive fair compensation, allowing them to focus on delivering compassionate, high-quality care. What We’re Looking For We are seeking a dedicated and knowledgeable Medicaid Health Insurance Specialist to join our team. The ideal candidate will possess a strong background in researching member insurance issues, counselling patients on insurance plans, and navigating the complexities of MassHealth LTSS services. This role is vital in ensuring that our patients receive the best possible insurance solutions tailored to their needs.

Requirements

• Minimum of 2 years of experience in Medicaid eligibility and enrollment.
• Proven experience with client interaction and willingness to travel to patients' homes.
• Strong interpersonal skills with the ability to engage with diverse populations and build rapport.
• Familiarity with LTSS services, including the benefits of various insurance plans.
• Willingness to undergo training to become a certified application counselor (CAC).
• General knowledge of prior authorizations in LTSS and services covered under Medicaid.
• Self-motivated and proactive approach to finding innovative solutions for patient needs.
• Strong communication skills to convey information clearly and effectively to patients and internal teams.

Nice To Haves

• Foundational knowledge in Personal Care Assistance (PCA) is strongly preferred.
• Experience in the insurance industry is strongly preferred.
• Fluency in both English and Spanish is preferred.

Responsibilities

• Assess and determine Medicaid eligibility for clients, utilizing the knowledge of LTSS services and the specific benefits associated with various forms and waivers of Medicaid.
• Provide guidance and counsel to patients regarding insurance plans, discussing risks and benefits to help them make informed choices.
• Engage with patients in their homes to assist with onboarding, ensuring a smooth transition into necessary services.
• Demonstrate a strong understanding of various plans with the Virginia health insurance system to aid clients in navigating their options.
• Research member insurance issues, addressing concerns related to benefits and eligibility, and help clients understand their options.
• Familiarize yourself with prior authorization processes related to LTSS and Medicaid services, including hospice services and personal care assistance (PCA).
• Display ambition and innovation in developing patient solutions through insurance options, constantly seeking to improve processes.
• Maintain a self-starter mentality by tracking key quantifiable metrics related to patient enrollment documents to enhance efficiency in the enrollment process.
• Practice keen listening skills to effectively connect with patients during insurance navigation, ensuring their needs are understood and met.
• Communicate effectively with internal staff regarding trends and issues related to insurance enrollment, fostering cooperative problem-solving.

Benefits

• 401(K)
• Health insurance
• Life insurance
• Dental insurance and Vision insurance.
• Comprehensive PTO including 11 paid holidays, paid time off (PTO), and sick leave.
• Employee Perks: Spending discounts via SmartSpend, financial coaching via SoFi, and pet insurance discounts for any furry friends!

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 51-100 employees