Social Services Coordinator

Solis Health Plans

5h•Onsite

About The Position

The Social Services Coordinator will apply working knowledge of the Florida Medicaid regulations and Social Security Administration to an assigned caseload in order to obtain and maximize, Qualified Medicare Beneficiary (QMB), Special Low-Income Medicare Beneficiary (SLMB), Qualify Individual (QI1), and Low-Income Subsidy (LIS). This position is fully onsite, from Monday-Friday.

Requirements

High School Diploma or equivalent combination of training and experience.
Understanding the Social Service goals and objectives in the managed care environment
Knowledge of computer software packages and operations, especially Word, Excel, and Outlook.
Able to communicate effectively in oral and written forms with internal staff, members, families, and providers.
Ability to work within set deadlines.
Professional, high degree of accuracy, detail oriented, confident and flexible.

Responsibilities

Conduct telephonic and mail outreach materials to members and prospects.
Assist members to complete application for state and federal Medicaid Programs.
Identify and pre-screen prospective members for the QMB, SLMB, QI1, and LIS.
Interview with clients and families and coordinates and plans for programs and activities to meet their social and/or emotional needs.
Comply with government regulations in all areas of responsibility required, i.e. signatures on all forms for Medicaid and LIS.
Follow up with the Department of Children and Families and Social Security Administration on Medicaid and LIS applications in a timely manner.
Prioritize daily duties and adapt quickly to changing responsibilities.
Maintain updated knowledge of existing and new regulations on Medicaid and Social Security.
Assist members as well as prospects in person or on the telephone with questions or concerns.
Maintain accurate and organized inventory of cases.
Able to work with other departments such as Sale, Case Management and Member Services.
Adheres and ensures compliance with Risk Management Program policies and adverse incident reporting.
Understands and interprets policies and procedures.
Ensures the compliance of CMS/AHCA rules and regulations that are being observed, as well as the HIPAA regulations as applied to PHI.
Other duties as assigned.