Medicaid Specialist
About The Position
Function(s): Provide Medicaid-related support to the HCBS Division JOB RESPONSIBILITIES: Provide enrollee-related support to Care Management and Assessment Departments and staff Initiate intake process for incoming assessments/enrollments. Process disenrollments in the appropriate documentation system. Serve as Liaison to partners—County Departments of Job and Family Services, Managed Care Organizations, Ohio Departments of Medicaid and Aging—related to eligibility and Share of Costs Monitor changes between systems and databases with Program partners Navigate databases and inform Care Managers/WSC of changes to Plans as appropriate Advocate for enrollee Medicaid approvals. Track approvals and resolved conflicts in the appropriate documentation system. Perform data entry of enrollee information into Program-specific database systems and portals Complete Program-specific monthly and quarterly reporting duties as assigned Provide ongoing Program-specific support duties for Supervisor and Care Managers/WSC regarding Medicaid, Enrollment information, Provider issues and other miscellaneous items Maintain Program-specific State Hearing requirements Support Provider-related issues including terminations, complaints and notify Case Managers of inactive Providers, as required by Waiver specifications Provide uploading support in Program and Agency-specific areas.
Requirements
- 1 year of relevant experience.
- High School diploma
Nice To Haves
- Intermediate experience with Microsoft Office programs including Excel, Outlook, Word and Access database use.
- Previous data entry experience
- Previous insurance billing experience
- Some college education
Responsibilities
- Provide enrollee-related support to Care Management and Assessment Departments and staff
- Initiate intake process for incoming assessments/enrollments.
- Process disenrollments in the appropriate documentation system.
- Serve as Liaison to partners—County Departments of Job and Family Services, Managed Care Organizations, Ohio Departments of Medicaid and Aging—related to eligibility and Share of Costs
- Monitor changes between systems and databases with Program partners
- Navigate databases and inform Care Managers/WSC of changes to Plans as appropriate
- Advocate for enrollee Medicaid approvals.
- Track approvals and resolved conflicts in the appropriate documentation system.
- Perform data entry of enrollee information into Program-specific database systems and portals
- Complete Program-specific monthly and quarterly reporting duties as assigned
- Provide ongoing Program-specific support duties for Supervisor and Care Managers/WSC regarding Medicaid, Enrollment information, Provider issues and other miscellaneous items
- Maintain Program-specific State Hearing requirements
- Support Provider-related issues including terminations, complaints and notify Case Managers of inactive Providers, as required by Waiver specifications
- Provide uploading support in Program and Agency-specific areas.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
