Medicaid Specialist | Revenue Cycle

Community Hospice & Palliative Care•Jacksonville, FL

2d•$55,000 - $60,000•Hybrid

About The Position

Under the direction of the Medicaid Eligibility Supervisor and the Director of Revenue Cycle Management, the Medicaid Eligibility Specialist is responsible for completing the Medicaid Application process for any applicable governmental medical assistance programs. S/he acts as an advocate for the patient and serves as a liaison to other team members and government agency staff in a collaborative effort to facilitate eligibility for incurred hospice and PACE medical expenses.Position Details Work Location: 60% in-office 40% around Duval county; no work from home at this time Compensation: $55,000 - $60,000 base salary plus any driving mileage; full benefits package including 23 days year PTO Days/Hours: Monday - Friday, 8:00am - 5:00pm

Requirements

Any combination of education and experience that would provide required skills and knowledge for successful performance would be qualifying.
Minimum of five years Medicaid experience
Frequent travel and field experience required
Current State of Florida driver’s license with driving record acceptable to CHNE, insurance carrier, reliable transportation

Nice To Haves

Associate degree, preferred.
Some skilled nursing business office experience desirable

Responsibilities

Review Hospice referrals/admits and contact patient/family to conduct a phone interview within 24 hours of admission to complete Medicaid pre-screening and determine potential eligibility.
Review PACE referrals and communicate with PACE intake staff within 48 hours of referral to confirm receipt of referral and provide an application update.
Schedule any applicable appointments with a patient or their representative to complete the application and collect all necessary releases, signatures, and documents within 5 business days of admission.
Complete the Medicaid application on-line using Access Florida website.
Work with patient/family or PACE representative to collect all documentation requested by DCF Caseworker needed to determine eligibility and obtain Medicaid approval within the DCF timeframe.
Communicate with PACE staff and Community Partners on the status of all pending prior applications and any outstanding documentation needed for approval.
Record daily all communication with patient/family, PACE, DCF, and LTC in Suncoast, and keep Medicaid pending spreadsheet always updated.
Track all re-certifications and communicate with PACE staff, patient/family and community partners on recertification requests received from DCF.
Contact Social Security Office to verify patient’s SS benefit or to assist patients applying for Social Security Benefits to allow for Medicaid approval.
Be able to assist the Admissions team in determining if a patient has Medicaid, the type of Medicaid, and if an application needs to be pursued.
Meet with patients/families needing financial assistance to complete the application and collect the necessary documentation.
Approve/deny the Request for Financial Assistance based on company policy and adjusted fee schedule.
Develop and maintain relationships with area social workers and community agency staff to network and facilitate Medicaid approvals
Other duties as assigned by Medicaid Supervisor and Director of Revenue Cycle Management.