Medicaid Tech

EveryAge•Lexington, NC

About The Position

Under the direction of the Business Office Lead, the Medicaid Technician is responsible for assisting potential enrollees and families in the application process for Medicaid and Level of Care for PACE. The Medicaid Tech will ensure that the appropriate county agency receives the application and requested supporting documents. Maintains log of Medicaid eligibility and PACE Level of Care schedule. Completes all determinations for participants and coordinates the communication with the State Agency for determining PACE Level of Care.

Requirements

High school diploma or equivalent is required.
Current Cardio Pulmonary Resuscitation (CPR) certification required.
Minimum of one year working with the frail or elderly.

Responsibilities

Assists participants and/or families to initiate the Medicaid approval process.
Performs home visits, as needed, to complete Medicaid applications on all new enrollees and redeterminations within a reasonable time frame and submits cases to county technicians within approved time frames. Completes all redeterminations for participants assigned to them 30 days before the case is due.
Works closely with families and participants in a timely manner to assist them in completing the paperwork needed for Medicaid eligibility.
Keeps the enrollment staff and health plan staff up to date on the status of participants who are in the Medicaid process and status of PACE Level of Care.
Maintains working knowledge of Medicaid rules and regulations and is able to communicate regulations confidently to participants and families (Straight Medicaid, LTC Medicaid, and Spousal Impoverishment and Trusts).
Maintains efficient and organized case load and work area.
Coordinates communications between Health Plan and State Agencies related to PACE Level of Care certification.
Maintains log of Medicaid eligibility and redetermination dates. Coordinates FL2 recertification date with Health Plan to prevent expiration of FL2.
Maintains participants' Medicaid files, keeping files updated and current.
Participates in community committees as representative of EveryAge PACE as appropriate with Health Plan Manager approval.
Practices Universal precautions and follow appropriate Infection Control procedures.
Maintains a safe working environment. Follow EveryAge PACE's Policies and Procedures and OSHA safety guidelines.
Protects privacy and maintain confidentiality of all company procedures, results, and information about employees, participants, clients, or families.
Participates in continuing education classes and any required staff and training meetings.
Performs other duties as required.